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Individual
MAIA ELIZ DEFOE
Active
Individual
MAIA ELIZ DEFOE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1588993091
—
MN
Enumeration date
07/11/2022
Last updated
07/11/2022
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