Individual
AWA MBYE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3042 MCKINLEY AVE, COLUMBUS, OH 43204-3653
(614) 487-7805
(614) 487-7809
Mailing address
1117 LANTERN TRAIL AVE UNIT 304, COLUMBUS, OH 43228-7445
(614) 589-1859
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/01/2020
Last updated
08/01/2020
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