Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YP2500X | Professional Counselor | 3855-125 | WI |
Y | 103K00000X | Behavior Analyst | 223-140 | WI |
NPI | 1003207200 |
---|---|
Provider Name | Christina Murphy |
First Address | Brookfield, WI 53005-6117 |
Second Address | Madison, WI 53719-2068 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/02/2015 |
Last Update Date | 14/01/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
223-140 | BCBA LICENSE (01) | WI |
3855-125 | PROFESSIONAL COUNSELOR LISCENCE (01) | WI |