Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst | 1591 | LA |
NPI | 1124652334 |
---|---|
Provider Name | Mrs. Patricia Rene Thompson |
First Address | Baton Rouge, LA 70806-3829 |
Second Address | Baton Rouge, LA 70806-3829 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/02/2020 |
Last Update Date | 26/02/2020 |