Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 106S00000X | Behavior Technician |
NPI | 1003386053 |
---|---|
Provider Name | Kaila Ogletree |
First Address | San Diego, CA 92111-3635 |
Second Address | San Diego, CA 92111-3635 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/12/2018 |
Last Update Date | 21/04/2021 |