Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst | 0167355 | VA |
NPI | 1083112916 |
---|---|
Provider Name | Sommer Gale Quantz |
First Address | Hot Springs, VA 24445-2111 |
Second Address | Hot Springs, VA 24445-2111 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/01/2018 |
Last Update Date | 25/01/2018 |