Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | 1-19-37499 | TX |
N | 106E00000X | Assistant Behavior Analyst |
NPI | 1093287153 |
---|---|
Provider Name | Shamica Morton |
First Address | Round Rock, TX 78665-4402 |
Second Address | Moreno Valley, CA 92557-5529 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/12/2018 |
Last Update Date | 20/04/2020 |