Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst | 0167373 | CA |
NPI | 1073055471 |
---|---|
Provider Name | Hannah Bernard |
First Address | Oceanside, CA 92058-1328 |
Second Address | Oceanside, CA 92058-1328 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/11/2016 |
Last Update Date | 16/11/2016 |