Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | 1-20-43716 | VA |
NPI | 1003494808 |
---|---|
Provider Name | Kaitlyn Lyford |
First Address | Lynchburg, VA 24501 |
Second Address | Lynchburg, VA 24501 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/04/2021 |
Last Update Date | 01/04/2021 |