Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | 1-20-45409 | CO |
N | 106E00000X | Assistant Behavior Analyst | 0-20-11291 | CO |
N | 106S00000X | Behavior Technician | RBT-18-65515 | CO |
NPI | 1134602279 |
---|---|
Provider Name | Juliana Plucinik |
First Address | Monument, CO 80132-9125 |
Second Address | Colorado Springs, CO 80920 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/09/2018 |
Last Update Date | 23/03/2021 |