Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst | 103K00000X | CA |
NPI | 1144762303 |
---|---|
Provider Name | Jamelia Rich |
First Address | Alta Loma, CA 91701-4659 |
Second Address | Monrovia, CA 91016-3406 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/11/2016 |
Last Update Date | 04/11/2016 |