Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst |
NPI | 1063082675 |
---|---|
Provider Name | Annika Wang |
First Address | Irvine, CA 92614-5554 |
Second Address | Ontario, CA 91764-5104 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2021 |
Last Update Date | 26/06/2021 |