Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst | 1-21-47523 | CA |
N | 106S00000X | Behavior Technician | RBT-18-64958 | CA |
NPI | 1164905576 |
---|---|
Provider Name | Michelle Schaub |
First Address | Irvine, CA 92606-2417 |
Second Address | City Of Industry, CA 91748-1779 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/09/2018 |
Last Update Date | 10/02/2021 |