Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst |
NPI | 1003389057 |
---|---|
Provider Name | Lily Shapiro |
First Address | Sonoma, CA 95476-6303 |
Second Address | Sonoma, CA 95476-6303 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/01/2019 |
Last Update Date | 02/01/2019 |