Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician |
NPI | 1003309170 |
---|---|
Provider Name | Aishah Hadiyyah Harley |
First Address | Deerfield Beach, FL 33441-1817 |
Second Address | Raleigh, NC 27601-3000 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2018 |
Last Update Date | 12/06/2018 |