Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | 1-14-15901 | ME |
NPI | 1003274259 |
---|---|
Provider Name | Mr. David Pulsifer |
First Address | Westbrook, ME 04092-4106 |
Second Address | Westbrook, ME 04092 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/02/2016 |
Last Update Date | 03/02/2016 |