Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | RBT-18-47191 | CA |
NPI | 1003316589 |
---|---|
Provider Name | Michelle Patricia Dove |
First Address | Woodland Hills, CA 91367-7807 |
Second Address | Los Angeles, CA 90064-5807 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/02/2018 |
Last Update Date | 20/02/2018 |