Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst |
NPI | 1003406372 |
---|---|
Provider Name | Tymra Ashley Morris |
First Address | Middleboro, MA 02346-1816 |
Second Address | Wellesley, MA 02481-1817 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/01/2021 |
Last Update Date | 21/01/2021 |