Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst |
NPI | 1083373617 |
---|---|
Provider Name | Kacie Cardenas |
First Address | Katy, TX 77449-2514 |
Second Address | Katy, TX 77449-2514 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/12/2021 |
Last Update Date | 10/12/2021 |