Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician |
NPI | 1003157439 |
---|---|
Provider Name | Marlee Wier |
First Address | Huntington Beach, CA 92649-1172 |
Second Address | Leesburg, VA 20175-2545 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/03/2013 |
Last Update Date | 05/10/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
110026265 | (05) | NC |