Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician | RBT-15-06357 | DC |
NPI | 1003335829 |
---|---|
Provider Name | Sean Kirwan |
First Address | Washington, DC 20009-5318 |
Second Address | Washington, DC 20009-5318 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2017 |
Last Update Date | 13/09/2017 |