Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst |
NPI | 1003188111 |
---|---|
Provider Name | Maurice Andrews |
First Address | North Las Vegas, NV 89032-4873 |
Second Address | North Las Vegas, NV 89032-4873 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/02/2012 |
Last Update Date | 04/02/2012 |