Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst | CO |
NPI | 1114316270 |
---|---|
Provider Name | Amy Ondrak |
First Address | Lakewood, CO 80226-2261 |
Second Address | Lakewood, CO 80226-2261 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/01/2015 |
Last Update Date | 29/05/2020 |