Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst | ||
N | 106S00000X | Behavior Technician | RBT-20-137056 |
NPI | 1063029734 |
---|---|
Provider Name | Jamie Gawthrop |
First Address | Hinesville, GA 31313-2636 |
Second Address | Hinesville, GA 31313-2636 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/09/2020 |
Last Update Date | 03/08/2021 |