Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst |
NPI | 1003252982 |
---|---|
Provider Name | Nekesha Tart |
First Address | Evanston, IL 60201-3978 |
Second Address | Evanston, IL 60201-3978 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2013 |
Last Update Date | 23/09/2016 |