Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst |
NPI | 1003330432 |
---|---|
Provider Name | Mrs. Sara Nicole Dodson |
First Address | East Lansing, MI 48823-1600 |
Second Address | Lansing, MI 48906-5457 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2017 |
Last Update Date | 27/07/2017 |