Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician | WA |
NPI | 1003425778 |
---|---|
Provider Name | Gabriella Maria Noyola |
First Address | Moses Lake, WA 98837-3800 |
Second Address | Moses Lake, WA 98837-3800 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2020 |
Last Update Date | 28/07/2020 |