Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | ||
N | 103TR0400X | Rehabilitation Psychologist |
NPI | 1114277829 |
---|---|
Provider Name | Michelle Victoria Sperry |
First Address | Reno, NV 89509-2345 |
Second Address | Reno, NV 89509-2345 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/09/2012 |
Last Update Date | 11/09/2012 |