Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | 11210089 | CA |
NPI | 1003365644 |
---|---|
Provider Name | Ms. Vanessa Lord |
First Address | Whittier, CA 90602-2475 |
Second Address | Whittier, CA 90602-2475 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/09/2016 |
Last Update Date | 23/09/2016 |