Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst |
NPI | 1003217530 |
---|---|
Provider Name | Brian A Clymer |
First Address | Fort Collins, CO 80525-3934 |
Second Address | Fort Collins, CO 80525-3934 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/09/2014 |
Last Update Date | 16/09/2014 |