Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst |
NPI | 1013240654 |
---|---|
Provider Name | Mrs. Melissa Jean Atwater |
First Address | Clermont, FL 34715-8069 |
Second Address | Clermont, FL 34711-2190 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/09/2009 |
Last Update Date | 15/09/2009 |