Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | ||
N | 103K00000X | Behavior Analyst | 1662 | TX |
NPI | 1003367442 |
---|---|
Provider Name | Krystina Way |
First Address | Houston, TX 77070-4406 |
Second Address | Houston, TX 77070-4406 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/10/2016 |
Last Update Date | 31/01/2019 |