Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst |
NPI | 1003380361 |
---|---|
Provider Name | Ashley Stefaniak |
First Address | Anaheim, CA 92801-5204 |
Second Address | Anaheim, CA 92801-5204 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/01/2019 |
Last Update Date | 12/02/2021 |