Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst | 000000 |
NPI | 1114434123 |
---|---|
Provider Name | Luz T. Gil |
First Address | Chula Vista, CA 91910-5158 |
Second Address | Chula Vista, CA 91910-5158 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/12/2017 |
Last Update Date | 29/12/2017 |