Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 106S00000X | Behavior Technician | ||
Y | 156F00000X | Technician/Technologist |
NPI | 1104462944 |
---|---|
Provider Name | Sunem Morales-Mendez |
First Address | Bingham Farms, MI 48025-2454 |
Second Address | Bingham Farms, MI 48025-2454 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/11/2019 |
Last Update Date | 15/02/2021 |