Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician |
NPI | 1003421934 |
---|---|
Provider Name | Jessica Capers |
First Address | Albuquerque, NM 87113-1946 |
Second Address | Englewood, CO 80112-6083 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/09/2020 |
Last Update Date | 08/09/2020 |