Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst |
NPI | 1003150251 |
---|---|
Provider Name | Kristen Elms |
First Address | Walnut Creek, CA 94596-4653 |
Second Address | Walnut Creek, CA 94596-4653 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/11/2012 |
Last Update Date | 11/11/2012 |