Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician |
NPI | 1003412081 |
---|---|
Provider Name | Alyssa Bernas |
First Address | Houston, TX 77065-1132 |
Second Address | Houston, TX 77065-1132 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/12/2020 |
Last Update Date | 07/12/2020 |