Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | ||
N | 106E00000X | Assistant Behavior Analyst |
NPI | 1134604994 |
---|---|
Provider Name | Jennifer Rose Harmon |
First Address | Santa Clara, CA 95054-3761 |
Second Address | San Jose, CA 95128 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/09/2018 |
Last Update Date | 12/08/2019 |