Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician |
NPI | 1003317462 |
---|---|
Provider Name | Alyssa Ann Holcomb |
First Address | Woodland Hills, CA 91367-4976 |
Second Address | Louisville, KY 40213-1978 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/02/2018 |
Last Update Date | 21/02/2018 |