Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician |
NPI | 1003400532 |
---|---|
Provider Name | Miriam De La Cruz Ahedo |
First Address | Salinas, CA 93907-2362 |
Second Address | Salinas, CA 93907-2362 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/02/2021 |
Last Update Date | 25/02/2021 |