Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst | BACB367726 |
NPI | 1023471984 |
---|---|
Provider Name | Courtney Foster |
First Address | Jacksonville, FL 32256-0322 |
Second Address | Fleming Island, FL 32003-7122 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/03/2016 |
Last Update Date | 10/12/2020 |