Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician | GA |
NPI | 1003406018 |
---|---|
Provider Name | Aliciante Parker |
First Address | Atlanta, GA 30303-1292 |
Second Address | Atlanta, GA 30303-1292 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/01/2021 |
Last Update Date | 23/01/2021 |