Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician |
NPI | 1003386251 |
---|---|
Provider Name | Olivia L Williams |
First Address | Clarksville, TN 37042-6684 |
Second Address | Clarksville, TN 37042-6684 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/11/2018 |
Last Update Date | 30/11/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
RBT | BEHAVIOR ANALYSIS CERTIFICATION BOARD (01) |