Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician |
NPI | 1003380932 |
---|---|
Provider Name | Leah Sparrowe |
First Address | Walnut Creek, CA 94598-2538 |
Second Address | Walnut Creek, CA 94598-2538 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/01/2019 |
Last Update Date | 14/01/2019 |