Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | 0133000326 | VA |
NPI | 1013334176 |
---|---|
Provider Name | Dolleen-Day Keohane |
First Address | Richmond, VA 23230-3011 |
Second Address | Richmond, VA 23230-3011 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2014 |
Last Update Date | 26/03/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0133000326 | LICENCE BEHAVIOR ANALYST (01) | VA |