Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | MI | |
N | 106E00000X | Assistant Behavior Analyst |
NPI | 1104399534 |
---|---|
Provider Name | Sophia Taylor |
First Address | South Pasadena, CA 91030-2694 |
Second Address | Los Angeles, CA 90017-1823 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/01/2019 |
Last Update Date | 09/08/2021 |