Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst |
NPI | 1013167865 |
---|---|
Provider Name | Holly Warner |
First Address | Cordova, TN 38018-8502 |
Second Address | Cordova, TN 38018-8502 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/09/2008 |
Last Update Date | 29/09/2008 |