Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician |
NPI | 1003385584 |
---|---|
Provider Name | Naana Asiedu |
First Address | Crofton, MD 21114-1314 |
Second Address | Crofton, MD 21114 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/11/2018 |
Last Update Date | 14/11/2019 |