Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst |
NPI | 1013341460 |
---|---|
Provider Name | Frances Marie Forsythe |
First Address | Dallas, OR 97338-2391 |
Second Address | Dallas, OR 97338-2391 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/08/2013 |
Last Update Date | 21/08/2013 |