Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician |
NPI | 1003423575 |
---|---|
Provider Name | Alaina Mckinnon |
First Address | Beaverton, OR 97006-7362 |
Second Address | Beaverton, OR 97006-7362 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/09/2020 |
Last Update Date | 28/09/2020 |