Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician |
NPI | 1003424664 |
---|---|
Provider Name | Phuong Le |
First Address | Pasadena, CA 91106-2380 |
Second Address | Huntington Beach, CA 92649-1060 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2020 |
Last Update Date | 20/07/2020 |