Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst |
NPI | 1003380163 |
---|---|
Provider Name | Miss Emily Anne Harrison |
First Address | San Pedro, CA 90731-6908 |
Second Address | Torrance, CA 90502-1351 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/01/2019 |
Last Update Date | 11/01/2019 |