Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst |
NPI | 1164958690 |
---|---|
Provider Name | Diane Elaine Caballero |
First Address | Oklahoma City, OK 73108-7228 |
Second Address | Oklahoma City, OK 73108-7228 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2017 |
Last Update Date | 03/05/2017 |