Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst |
NPI | 1164193835 |
---|---|
Provider Name | Isela Flores |
First Address | Carson, CA 90746-7126 |
Second Address | Fullerton, CA 92832-1612 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/09/2021 |
Last Update Date | 23/09/2021 |