Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | 0-11-4100 | CA |
NPI | 1013205988 |
---|---|
Provider Name | Ms. Ashley Carolanne Adams |
First Address | San Diego, CA 92121-5795 |
Second Address | San Diego, CA 92121-5795 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2011 |
Last Update Date | 13/07/2011 |