Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | 1-14-17139 | CA |
N | 103K00000X | Behavior Analyst | BCABA 0-11-4296 | CA |
NPI | 1013251651 |
---|---|
Provider Name | Lindsey Dodds |
First Address | La Mesa, CA 91942-0335 |
Second Address | San Diego, CA 92108-3763 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/11/2012 |
Last Update Date | 09/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1-14-17139 | BACB (01) | CA |