Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | BA60768613 | WA |
NPI | 1013183649 |
---|---|
Provider Name | Mr. Neill Dorn |
First Address | Seattle, WA 98112-2606 |
Second Address | Seattle, WA 98112-2606 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2008 |
Last Update Date | 22/03/2018 |