Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | WA | |
N | 106E00000X | Assistant Behavior Analyst | WA | |
N | 106S00000X | Behavior Technician | WA |
NPI | 1013515766 |
---|---|
Provider Name | Anjela Kadoma |
First Address | Spokane, WA 99208-1108 |
Second Address | Spokane, WA 99208-1108 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/10/2020 |
Last Update Date | 14/10/2020 |