Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician | A770672 | OR |
NPI | 1003308834 |
---|---|
Provider Name | Alize Markson |
First Address | Woodland Hills, CA 91367-7807 |
Second Address | Salem, OR 97301-5861 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2018 |
Last Update Date | 06/06/2018 |