Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician |
NPI | 1003406430 |
---|---|
Provider Name | Gabriella Elizabeth Inman |
First Address | Worcester, MA 01607-1753 |
Second Address | Worcester, MA 01607-1753 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/01/2021 |
Last Update Date | 20/01/2021 |