Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst |
NPI | 1104331503 |
---|---|
Provider Name | Amanda Denier |
First Address | Omaha, NE 68137-1111 |
Second Address | Omaha, NE 68137-1111 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/12/2017 |
Last Update Date | 07/01/2019 |