Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | L-555 | LA |
N | 106E00000X | Assistant Behavior Analyst | C-079 | LA |
N | 106S00000X | Behavior Technician |
NPI | 1013417716 |
---|---|
Provider Name | Nathaniel Mullins |
First Address | Woodland Hills, CA 91367-7807 |
Second Address | Baton Rouge, LA 70802-6433 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/02/2018 |
Last Update Date | 01/09/2021 |