Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | 1-14-16383 | CA |
NPI | 1013323120 |
---|---|
Provider Name | Leah Birdsong |
First Address | Sacramento, CA 95826-9716 |
Second Address | Sacramento, CA 95826-9716 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/07/2014 |
Last Update Date | 29/08/2014 |