Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | WI |
NPI | 1003481565 |
---|---|
Provider Name | Melissa Sue Mach |
First Address | Neenah, WI 54956-2941 |
Second Address | Neenah, WI 54956-2941 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/05/2021 |
Last Update Date | 26/05/2021 |