Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst |
NPI | 1003421587 |
---|---|
Provider Name | Samantha Cortes |
First Address | Pasadena, CA 91106-2380 |
Second Address | Worcester, MA 01605-3909 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/09/2020 |
Last Update Date | 11/09/2020 |