Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst |
NPI | 1164922415 |
---|---|
Provider Name | Adrienne Patterson |
First Address | Las Vegas, NV 89130-1172 |
Second Address | Las Vegas, NV 89183-5924 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/02/2018 |
Last Update Date | 13/02/2018 |