Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst |
NPI | 1013257963 |
---|---|
Provider Name | Diana Jones |
First Address | N Las Vegas, NV 89032-7676 |
Second Address | N Las Vegas, NV 89032-7676 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/02/2013 |
Last Update Date | 28/02/2013 |