Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst |
NPI | 1003421058 |
---|---|
Provider Name | Kaitlyn Parker |
First Address | Lake Charles, LA 70605-5900 |
Second Address | Lake Charles, LA 70605-5900 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/09/2020 |
Last Update Date | 05/03/2021 |