Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 106E00000X | Assistant Behavior Analyst | ||
Y | 106S00000X | Behavior Technician |
NPI | 1053953562 |
---|---|
Provider Name | Rochelle Nicole Dohermann |
First Address | Woodland Hills, CA 91367-4976 |
Second Address | Silverdale, WA 98383-7669 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/10/2019 |
Last Update Date | 16/10/2019 |