Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician | RBT-20-113168 | CA |
NPI | 1003427865 |
---|---|
Provider Name | Richa Wadhawan |
First Address | Perris, CA 92571-4101 |
Second Address | Perris, CA 92571-4101 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/08/2020 |
Last Update Date | 13/08/2020 |