Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician | RBT-20-138645 | TX |
NPI | 1003410002 |
---|---|
Provider Name | Ms. Leah Sollenne |
First Address | Stuart, FL 34997-7462 |
Second Address | Irving, TX 75039-3602 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/11/2020 |
Last Update Date | 30/11/2020 |