Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician |
NPI | 1003383860 |
---|---|
Provider Name | Nancy Pullen |
First Address | Fairfield, CA 94533-8716 |
Second Address | Dublin, CA 94568-2796 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/10/2018 |
Last Update Date | 30/10/2018 |