Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | 1-21-51126 | CA |
N | 106E00000X | Assistant Behavior Analyst |
NPI | 1063063931 |
---|---|
Provider Name | Marilyn Nicole Artinian |
First Address | South Lake Tahoe, CA 96150-7978 |
Second Address | South Lake Tahoe, CA 96150-7978 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/09/2019 |
Last Update Date | 07/07/2021 |