Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | F1522677 | CA |
NPI | 1013360817 |
---|---|
Provider Name | Ida Milani |
First Address | Mountain View, CA 94040-4561 |
Second Address | San Mateo, CA 94401-1653 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/07/2016 |
Last Update Date | 15/07/2016 |