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Individual
TIA LATRICE STEWART
Active
Individual
TIA LATRICE STEWART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-22-63257
AR
106S00000X
Behavior Technician
RBT-21-165152
AR
Other
Enumeration date
04/05/2022
Last updated
12/22/2022
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