Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 106E00000X | Assistant Behavior Analyst | ||
Y | 106S00000X | Behavior Technician | FL |
NPI | 1053843698 |
---|---|
Provider Name | Annmarie Granja |
First Address | San Diego, CA 92121-1436 |
Second Address | San Diego, CA 92121 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/04/2017 |
Last Update Date | 07/12/2018 |