Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | 7401000355 | MI |
N | 225C00000X | Rehabilitation Counselor | 00213530 | MI |
NPI | 1053809293 |
---|---|
Provider Name | Richard Albert Price |
First Address | Champaign, IL 61820-2048 |
Second Address | Champaign, IL 61820-2048 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2018 |
Last Update Date | 10/08/2020 |