Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | 0133001577 | VA |
N | 106E00000X | Assistant Behavior Analyst | 0134000228 | VA |
NPI | 1104210855 |
---|---|
Provider Name | Alejandro Solis |
First Address | Manassas, VA 20109-3554 |
Second Address | Manassas, VA 20109 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2015 |
Last Update Date | 10/01/2020 |