Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician | RBT-17-44453 | CA |
NPI | 1003309501 |
---|---|
Provider Name | Kathryn Laski |
First Address | Irvine, CA 92606-2417 |
Second Address | El Cajon, CA 92020-5128 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2018 |
Last Update Date | 30/12/2021 |