Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | 1-15-19365 | TX |
NPI | 1013303312 |
---|---|
Provider Name | Cassandra Milliken |
First Address | Laguna Niguel, CA 92677-3754 |
Second Address | Laguna Niguel, CA 92677-3754 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/04/2015 |
Last Update Date | 09/03/2020 |