Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst |
NPI | 1013587237 |
---|---|
Provider Name | Logan Walker |
First Address | Bakersfield, CA 93309-0705 |
Second Address | Bakersfield, CA 93309-0705 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2021 |
Last Update Date | 29/06/2021 |