Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician | RBT-20-145543 | NV |
NPI | 1003410820 |
---|---|
Provider Name | Linda Ashley Gonzalez |
First Address | North Las Vegas, NV 89031-3845 |
Second Address | North Las Vegas, NV 89031-3845 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/11/2020 |
Last Update Date | 23/11/2020 |