Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | 1-14-16312 |
NPI | 1003225111 |
---|---|
Provider Name | Maria Loudermilk |
First Address | Huntington, WV 25701-1611 |
Second Address | Huntington, WV 25701-1611 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/08/2014 |
Last Update Date | 09/01/2017 |