Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | 1-08-4628 | FL |
NPI | 1013362037 |
---|---|
Provider Name | Mr. William Joseph Kent IV |
First Address | Oakland, CA 94611-2911 |
Second Address | Oakland, CA 94611-2911 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/04/2016 |
Last Update Date | 23/04/2020 |