Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | 1-16-23759 | CA |
NPI | 1003159245 |
---|---|
Provider Name | Mrs. Jamie Jean Enns |
First Address | Glendale, CA 91203-1906 |
Second Address | Newhall, CA 91321-2900 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/04/2013 |
Last Update Date | 29/09/2016 |