Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst |
NPI | 1003361981 |
---|---|
Provider Name | Danielle Nicole Wiemholt |
First Address | San Luis Obispo, CA 93401-7736 |
Second Address | San Luis Obispo, CA 93401-7736 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/08/2016 |
Last Update Date | 16/08/2018 |