Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst |
NPI | 1013258557 |
---|---|
Provider Name | Christine Benedetti |
First Address | Sparks, NV 89435-0843 |
Second Address | Sparks, NV 89436-2503 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/03/2013 |
Last Update Date | 17/04/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1-119505 | BOARD CERTIFIED BEHAVIOR ANALYST (01) | NV |
LBA0037 | LICENSED BEHAVIOR ANALYST (STATE OF NEVADA) (01) | NV |