Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst |
NPI | 1073017125 |
---|---|
Provider Name | Jackie Melcher |
First Address | San Francisco, CA 94103-2485 |
Second Address | Hayward, CA 94541-2952 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/03/2018 |
Last Update Date | 22/03/2018 |