Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103K00000X | Behavior Analyst | 0-13-5746 | CA |
Y | 106E00000X | Assistant Behavior Analyst | 0-13-5746 | OR |
NPI | 1063835858 |
---|---|
Provider Name | Dahlia Coenen |
First Address | Santa Ana, CA 92705-5504 |
Second Address | Santa Ana, CA 92705-5504 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/01/2014 |
Last Update Date | 17/03/2018 |