Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | 00031428 | AR |
NPI | 1013219484 |
---|---|
Provider Name | Ms. Sandra Lee Cochran |
First Address | Fort Smith, AR 72903-4408 |
Second Address | Poteau, OK 74953-2617 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/11/2010 |
Last Update Date | 17/11/2010 |