Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | 1-12-12398 | CA |
NPI | 1003151242 |
---|---|
Provider Name | Cal E Manska |
First Address | Valencia, CA 91355-1029 |
Second Address | Valencia, CA 91355-1029 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/11/2012 |
Last Update Date | 28/11/2012 |