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Individual
REED BANNER
Active
Individual
REED BANNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
247200000X
Other Technician
—
MI
261QC1500X
Community Health Clinic/Center
1689233579
NV
Other
Enumeration date
07/21/2021
Last updated
12/28/2022
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