Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician |
NPI | 1003403445 |
---|---|
Provider Name | Rida Fatima Rajani |
First Address | Plymouth, MI 48170-3962 |
Second Address | Plymouth, MI 48170-3962 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/12/2020 |
Last Update Date | 30/12/2020 |