Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst |
NPI | 1003089897 |
---|---|
Provider Name | Bethany Holton |
First Address | Nashville, TN 37205-1444 |
Second Address | Nashville, TN 37205-1444 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2008 |
Last Update Date | 22/01/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1511682 | (05) | TN |