Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | 0134000364 | VA |
NPI | 1003491580 |
---|---|
Provider Name | Christen Sikes |
First Address | Henrico, VA 23229-3862 |
Second Address | Midlothian, VA 23113-2655 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/03/2021 |
Last Update Date | 16/03/2021 |