Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103K00000X | Behavior Analyst | 1-14-10236 | CA |
NPI | 1013330620 |
---|---|
Provider Name | Miss Stephanie Ariana Acevedo |
First Address | Huntington Beach, CA 92649-2273 |
Second Address | Huntington Beach, CA 92649-2273 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/02/2014 |
Last Update Date | 16/05/2019 |