Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | 1-14-9447 | TX |
NPI | 1003329723 |
---|---|
Provider Name | Gary Gene Sarli |
First Address | Lytle, TX 78052-3481 |
Second Address | Lytle, TX 78052-3481 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/11/2017 |
Last Update Date | 17/03/2018 |