Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst |
NPI | 1013349125 |
---|---|
Provider Name | Lauren Enriquez |
First Address | San Diego, CA 92103-5355 |
Second Address | San Diego, CA 92103-4321 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/07/2013 |
Last Update Date | 03/05/2018 |