Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst |
NPI | 1013282714 |
---|---|
Provider Name | Ms. Sandra Houston |
First Address | Las Vegas, NV 89115-0372 |
Second Address | Las Vegas, NV 89115-0372 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/03/2012 |
Last Update Date | 13/03/2012 |