Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | B62706592 | VA |
NPI | 1003486762 |
---|---|
Provider Name | Sharon Aviles |
First Address | Woodland Hills, CA 91367-7807 |
Second Address | Manassas, VA 20110-4418 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2021 |
Last Update Date | 25/06/2021 |