Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst |
NPI | 1003240300 |
---|---|
Provider Name | Bryan Daseler |
First Address | Reno, NV 89502-6357 |
Second Address | Reno, NV 89509-4775 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/08/2013 |
Last Update Date | 22/08/2013 |