Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician |
NPI | 1003412503 |
---|---|
Provider Name | Chika Chinedu-Obi |
First Address | Tucson, AZ 85715 |
Second Address | Tucson, AZ 85715 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/12/2020 |
Last Update Date | 09/12/2020 |