Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | ||
N | 103T00000X | Psychologist | ||
Y | 106S00000X | Behavior Technician |
NPI | 1013421437 |
---|---|
Provider Name | Lisa Kaiser |
First Address | Albuquerque, NM 87113-1861 |
Second Address | Albuquerque, NM 87113-1861 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/11/2017 |
Last Update Date | 21/11/2017 |