Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) | R1371851119 | CA |
N | 106E00000X | Assistant Behavior Analyst | ||
N | 106S00000X | Behavior Technician | ||
N | 106S00000X | Behavior Technician | 00005178 | CA |
NPI | 1083114706 |
---|---|
Provider Name | Chad Prince Armstrong |
First Address | Placerville, CA 95667-4406 |
Second Address | Placerville, CA 95667-4406 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/02/2018 |
Last Update Date | 18/02/2021 |