Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst |
NPI | 1003371550 |
---|---|
Provider Name | Muchere Lewanda Freeman |
First Address | Brooklyn, NY 11210-2927 |
Second Address | Brooklyn, NY 11210-2927 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/02/2019 |
Last Update Date | 08/02/2019 |