Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst | HI |
NPI | 1124580378 |
---|---|
Provider Name | Cierra Nascimento |
First Address | Kaneohe, HI 96744-2720 |
Second Address | Kaneohe, HI 96744-2720 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2019 |
Last Update Date | 04/04/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
RBT-19-81187 | KAISER (01) | HI |