Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician |
NPI | 1003370628 |
---|---|
Provider Name | Catherine Elizabeth Comardelle |
First Address | Deerfield Beach, FL 33441-1817 |
Second Address | Metairie, LA 70006-6713 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/01/2019 |
Last Update Date | 28/01/2019 |