Individual
GENEVIEVE FENTRESS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-09-5102
—
Other
Enumeration date
10/15/2010
Last updated
10/15/2010
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