Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst | 7402000049 | MI |
N | 106S00000X | Behavior Technician |
NPI | 1003314238 |
---|---|
Provider Name | Rachel Adams |
First Address | East Tawas, MI 48730-1272 |
Second Address | East Tawas, MI 48730-1272 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/01/2018 |
Last Update Date | 01/10/2021 |