Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician |
NPI | 1003404203 |
---|---|
Provider Name | Psyterica Sade' Morris |
First Address | San Francisco, CA 94139-9318 |
Second Address | Duluth, GA 30097-8912 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/01/2021 |
Last Update Date | 04/01/2021 |