Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst | BH003262 | PA |
NPI | 1124616800 |
---|---|
Provider Name | Lauren Zirkle |
First Address | Bridgeville, PA 15017-3484 |
Second Address | Bridgeville, PA 15017-3484 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/01/2021 |
Last Update Date | 07/01/2021 |