Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst |
NPI | 1003389701 |
---|---|
Provider Name | Rachel Paugh |
First Address | Warrenton, VA 20187-9282 |
Second Address | Warrenton, VA 20187-9282 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/01/2019 |
Last Update Date | 04/01/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A66098100 | VA DRIVERS LICENSE (01) | VA |