Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst | GA |
NPI | 1073817193 |
---|---|
Provider Name | Robin Osborne |
First Address | Mcdonough, GA 30253-8701 |
Second Address | Mcdonough, GA 30253 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/01/2011 |
Last Update Date | 11/07/2018 |