Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst |
NPI | 1003304353 |
---|---|
Provider Name | Shianne Pierce |
First Address | Newport, MI 48166-9045 |
Second Address | Newport, MI 48166-9045 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/04/2018 |
Last Update Date | 23/04/2018 |