Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | CA |
NPI | 1003278458 |
---|---|
Provider Name | Brittany Moraga |
First Address | North Hollywood, CA 91605-6547 |
Second Address | Encino, CA 91436-5050 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/03/2016 |
Last Update Date | 24/03/2016 |