Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician |
NPI | 1003314105 |
---|---|
Provider Name | Jillian Bartolini |
First Address | Baltimore, MD 21218-4199 |
Second Address | Baltimore, MD 21218-4199 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/01/2018 |
Last Update Date | 24/01/2018 |