Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 106S00000X | Behavior Technician | ||
Y | 106S00000X | Behavior Technician | WA |
NPI | 1003414681 |
---|---|
Provider Name | Jacquelyn Hoston |
First Address | Spokane, WA 99208-1108 |
Second Address | Spokane, WA 99208-1108 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/10/2020 |
Last Update Date | 15/10/2020 |