Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 106E00000X | Assistant Behavior Analyst | KS | |
Y | 106S00000X | Behavior Technician | KS |
NPI | 1174058515 |
---|---|
Provider Name | Elizabeth F Palone |
First Address | Wichita, KS 67220-2106 |
Second Address | Wichita, KS 67220-2106 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2017 |
Last Update Date | 24/04/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1942649116 | (05) | KS |