Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | 1-14-9668 | NJ |
NPI | 1003213133 |
---|---|
Provider Name | Amanda Lipinski |
First Address | Honolulu, HI 96826-4612 |
Second Address | Kailua, HI 96734-2547 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/12/2014 |
Last Update Date | 04/12/2014 |