Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | 1-21-51305 | NC |
N | 106S00000X | Behavior Technician |
NPI | 1003479338 |
---|---|
Provider Name | Molly Diehl |
First Address | Cary, NC 27511-7903 |
Second Address | Cary, NC 27511-7903 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/04/2019 |
Last Update Date | 24/08/2021 |