Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 106E00000X | Assistant Behavior Analyst | 106E00000X | NY |
Y | 106E00000X | Assistant Behavior Analyst | 106E0000O | |
N | 106S00000X | Behavior Technician | 106S00000X | NY |
NPI | 1164181343 |
---|---|
Provider Name | Romell Scroggins |
First Address | Brooklyn, NY 11210-3025 |
Second Address | Brooklyn, NY 11210-3025 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/12/2021 |
Last Update Date | 15/12/2021 |