Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | 1-14-9954 | CA |
NPI | 1003364399 |
---|---|
Provider Name | Mr. Lorne Card |
First Address | Pasadena, CA 91106-4207 |
Second Address | Pasadena, CA 91106-4207 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/09/2016 |
Last Update Date | 14/09/2016 |