Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst | CA |
NPI | 1144973595 |
---|---|
Provider Name | Michelle Castanaza Gudiel |
First Address | Lancaster, CA 93534-2714 |
Second Address | Lancaster, CA 93534-2714 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/01/2022 |
Last Update Date | 26/01/2022 |