Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician | ||
N | 156F00000X | Technician/Technologist |
NPI | 1134692635 |
---|---|
Provider Name | Winstecia Thomas |
First Address | Van Buren Twp, MI 48111-4753 |
Second Address | Ann Arbor, MI 48103-9755 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/01/2019 |
Last Update Date | 06/11/2020 |