Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst | 0-19-10671 | GA |
NPI | 1063052611 |
---|---|
Provider Name | Rebecca Lynn Allen |
First Address | Lake Mary, FL 32746-5028 |
Second Address | Smyrna, GA 30080-4234 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/01/2020 |
Last Update Date | 22/06/2020 |