Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | 1-18-33744 | NC |
NPI | 1003471905 |
---|---|
Provider Name | Katherine Joyce Smith |
First Address | Raleigh, NC 27615-5096 |
Second Address | Raleigh, NC 27615-5096 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/05/2019 |
Last Update Date | 06/05/2019 |