Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst | ||
N | 106S00000X | Behavior Technician |
NPI | 1023524279 |
---|---|
Provider Name | Mr. Gary Wright JR. |
First Address | Irvine, CA 92606-2417 |
Second Address | Aiea, HI 96701-5012 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/12/2017 |
Last Update Date | 12/07/2021 |