Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician | F7263503 | CA |
NPI | 1003319187 |
---|---|
Provider Name | Skye Nicolette White |
First Address | Sacramento, CA 95816-5417 |
Second Address | Roseville, CA 95678-7040 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2018 |
Last Update Date | 14/03/2018 |