Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst |
NPI | 1023761657 |
---|---|
Provider Name | Selina Antonia Paxtor |
First Address | Loma Linda, CA 92354-3328 |
Second Address | Culver City, CA 90230-5956 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/02/2022 |
Last Update Date | 02/02/2022 |