Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | 11519521 | CA |
NPI | 1003287830 |
---|---|
Provider Name | Natalie Smith |
First Address | Sacramento, CA 95827-3334 |
Second Address | Sacramento, CA 95827-3334 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/10/2015 |
Last Update Date | 20/10/2015 |