Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician | RBT-18-73205 |
NPI | 1003370172 |
---|---|
Provider Name | Bernadette Carey |
First Address | Nashville, TN 37217-2679 |
Second Address | King Of Prussia, PA 19406-1209 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/01/2019 |
Last Update Date | 23/01/2019 |