Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | ||
N | 106S00000X | Behavior Technician |
NPI | 1003327149 |
---|---|
Provider Name | Meri Boyadzhyan |
First Address | Van Nuys, CA 91405-1754 |
Second Address | Van Nuys, CA 91405-1754 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/10/2017 |
Last Update Date | 16/10/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
94324460A27256 | MEDICAL (01) | CA |