Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | 1-07-3587 |
NPI | 1003118597 |
---|---|
Provider Name | Mariann Lai |
First Address | Flushing, NY 11355-4640 |
Second Address | Flushing, NY 11355-4640 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/12/2010 |
Last Update Date | 03/12/2010 |