Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103K00000X | Behavior Analyst | ||
Y | 106E00000X | Assistant Behavior Analyst | ||
N | 106S00000X | Behavior Technician |
NPI | 1023625746 |
---|---|
Provider Name | Omolara Akinola |
First Address | Black Jack, MO 63033-7511 |
Second Address | Black Jack, MO 63033-7511 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/09/2020 |
Last Update Date | 27/09/2020 |