Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst | 0-18-8856 | SC |
NPI | 1043706989 |
---|---|
Provider Name | Miss Amanda Lanoir |
First Address | Cowpens, SC 29330-9134 |
Second Address | Inman, SC 29349-7210 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2018 |
Last Update Date | 03/07/2018 |