Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst | CO |
NPI | 1144888389 |
---|---|
Provider Name | Maya Nelson |
First Address | Lakewood, CO 80228-6514 |
Second Address | Colorado Springs, CO 80918-3446 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/06/2019 |
Last Update Date | 03/06/2019 |