Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | 1-09-5796 | FL |
NPI | 1013239300 |
---|---|
Provider Name | Carlton Sutton |
First Address | Waldorf, MD 20603-4245 |
Second Address | Waldorf, MD 20603-4245 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/02/2010 |
Last Update Date | 27/02/2010 |