Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician |
NPI | 1003413451 |
---|---|
Provider Name | John Paulo Adriano Laggui |
First Address | Fort Worth, TX 76112-4210 |
Second Address | Lunenburg, MA 01462-2167 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/10/2020 |
Last Update Date | 07/10/2020 |