Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician |
NPI | 1003381559 |
---|---|
Provider Name | Paige Alexandra Macqueen |
First Address | Richmond, TX 77407-1428 |
Second Address | Pearland, TX 77581-7879 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/10/2018 |
Last Update Date | 11/10/2018 |