Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst |
NPI | 1093357212 |
---|---|
Provider Name | Balie Neel |
First Address | Claremore, OK 74017-3159 |
Second Address | Claremore, OK 74017-3159 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/10/2019 |
Last Update Date | 09/10/2019 |