Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst |
NPI | 1083098552 |
---|---|
Provider Name | Jennifer Stacie Chafey |
First Address | Albuquerque, NM 87109-4539 |
Second Address | Albuquerque, NM 87109-4539 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/07/2015 |
Last Update Date | 19/01/2021 |