Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | 0133001869 | VA |
N | 106E00000X | Assistant Behavior Analyst | 0134000318 | VA |
NPI | 1003431503 |
---|---|
Provider Name | Mrs. Rhiannon Violette Bailey |
First Address | Roanoke, VA 24018-6515 |
Second Address | Roanoke, VA 24018-6515 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2020 |
Last Update Date | 30/12/2020 |