Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 106E00000X | Assistant Behavior Analyst |
NPI | 1124549506 |
---|---|
Provider Name | Hue Phung |
First Address | Lakewood, CO 80226-2261 |
Second Address | Lakewood, CO 80226-2261 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2017 |
Last Update Date | 01/11/2017 |