Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst |
NPI | 1083230601 |
---|---|
Provider Name | Rachel Ruth Wyre |
First Address | Summersville, WV 26651-1796 |
Second Address | Summersville, WV 26651-1796 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/06/2020 |
Last Update Date | 19/06/2020 |