Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 106E00000X | Assistant Behavior Analyst | 0-17-8412 | CA |
NPI | 1073897534 |
---|---|
Provider Name | Amy Elizabeth Adams |
First Address | Marina, CA 93933-5111 |
Second Address | Marina, CA 93933-5111 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2011 |
Last Update Date | 19/04/2019 |