Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103K00000X | Behavior Analyst |
NPI | 1013321355 |
---|---|
Provider Name | Miss Lia Patrice Seidl |
First Address | Saint Francis, MN 55070-7810 |
Second Address | Saint Francis, MN 55070-7810 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2014 |
Last Update Date | 15/06/2014 |