Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst |
NPI | 1003452129 |
---|---|
Provider Name | Gerry Ann Duarte-Laabs I |
First Address | Menifee, CA 92584-8976 |
Second Address | Menifee, CA 92584-8976 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/11/2019 |
Last Update Date | 24/11/2019 |