Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | BEH-000400 | AZ |
NPI | 1003470584 |
---|---|
Provider Name | Carley L Perlman |
First Address | Phoenix, AZ 85004-1472 |
Second Address | Phoenix, AZ 85029-4378 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/04/2019 |
Last Update Date | 30/04/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1-18-32831 | BOARD ANALYST CERTIFICATION BOARD (01) | |
BEH-000400 | AZ STATE BOARD OF PSYCHOLOGIST EXAMINERS (01) | AZ |