Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | 1-17-28213 | CA |
NPI | 1013139963 |
---|---|
Provider Name | Adriana Spell |
First Address | Oceanside, CA 92058-1326 |
Second Address | San Diego, CA 92108-3743 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/05/2007 |
Last Update Date | 30/01/2018 |