Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103K00000X | Behavior Analyst | ||
N | 106E00000X | Assistant Behavior Analyst | ||
Y | 106S00000X | Behavior Technician |
NPI | 1023641776 |
---|---|
Provider Name | Kelsy Haider |
First Address | Lakeland, FL 33807-6553 |
Second Address | Overland Park, KS 66213-4333 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/02/2020 |
Last Update Date | 28/04/2021 |