Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician |
NPI | 1003380379 |
---|---|
Provider Name | Ashley Rae Canfield |
First Address | El Paso, TX 79936-2170 |
Second Address | El Paso, TX 79936-2170 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/01/2019 |
Last Update Date | 19/01/2019 |