Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst |
NPI | 1013492982 |
---|---|
Provider Name | Erin Orchid |
First Address | Fair Oaks, CA 95628-7156 |
Second Address | Fair Oaks, CA 95628-7156 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/09/2018 |
Last Update Date | 26/09/2018 |