Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician |
NPI | 1003379710 |
---|---|
Provider Name | Marissa Bhatnagar |
First Address | New Braunfels, TX 78132-4785 |
Second Address | New Braunfels, TX 78132-4785 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/04/2019 |
Last Update Date | 09/04/2019 |