Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician | ||
N | 156F00000X | Technician/Technologist |
NPI | 1063036838 |
---|---|
Provider Name | Sheril Amilia Rolston |
First Address | Saint Louis, MI 48880 |
Second Address | Saint Louis, MI 48880 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2020 |
Last Update Date | 06/04/2021 |