Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | 1-11-7964 | OH |
N | 103K00000X | Behavior Analyst | 1-11-7964 | PA |
NPI | 1013272814 |
---|---|
Provider Name | Mrs. Colleen S Larned |
First Address | Lyndhurst, OH 44124-1309 |
Second Address | Lyndhurst, OH 44124-1309 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2012 |
Last Update Date | 10/05/2016 |