Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst |
NPI | 1083119986 |
---|---|
Provider Name | Kathleen C. Ross |
First Address | Howard Beach, NY 11414-4026 |
Second Address | Bronx, NY 10451-5625 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/03/2018 |
Last Update Date | 24/03/2018 |