Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician |
NPI | 1003423146 |
---|---|
Provider Name | Emily Dee Vi |
First Address | Fountain Valley, CA 92708-4007 |
Second Address | Santa Ana, CA 92705-5504 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/09/2020 |
Last Update Date | 23/09/2020 |