Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst |
NPI | 1003464835 |
---|---|
Provider Name | Mrs. Rebecca Ann Leiter |
First Address | Orleans, MI 48865-9738 |
Second Address | Stanton, MI 48888-8601 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/08/2019 |
Last Update Date | 26/08/2019 |