Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst | ||
N | 106S00000X | Behavior Technician |
NPI | 1134685936 |
---|---|
Provider Name | Natily Dogom |
First Address | Studio City, CA 91604-1355 |
Second Address | Studio City, CA 91604-1355 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/02/2019 |
Last Update Date | 16/02/2019 |