Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 106S00000X | Behavior Technician |
NPI | 1003305061 |
---|---|
Provider Name | Alison Yang |
First Address | Bloomington, MN 55420-4800 |
Second Address | Bloomington, MN 55420-4800 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/05/2018 |
Last Update Date | 05/08/2020 |