Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | 1-21-54371 |
NPI | 1013316959 |
---|---|
Provider Name | Jessica Richardson |
First Address | Woodland Hills, CA 91367-7807 |
Second Address | Fairport, NY 14450-1581 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2014 |
Last Update Date | 07/01/2022 |