Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst |
NPI | 1154099067 |
---|---|
Provider Name | Emilia Reyes |
First Address | Westminster, CA 92683-2939 |
Second Address | Fresno, CA 93704-1540 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/09/2021 |
Last Update Date | 07/09/2021 |