Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician |
NPI | 1003310657 |
---|---|
Provider Name | Sarah Elizabeth Burson |
First Address | Silver Spring, MD 20910-4918 |
Second Address | North Bethesda, MD 20852-2539 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2018 |
Last Update Date | 20/03/2018 |