Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician |
NPI | 1003317223 |
---|---|
Provider Name | Angela Roszkowski |
First Address | Woodland Hills, CA 91367-4976 |
Second Address | Virginia Beach, VA 23452-7392 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/02/2018 |
Last Update Date | 22/02/2018 |