Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103K00000X | Behavior Analyst | CA | |
N | 106E00000X | Assistant Behavior Analyst | ||
Y | 106S00000X | Behavior Technician |
NPI | 1104579796 |
---|---|
Provider Name | Stephen Harry Dodson |
First Address | Temecula, CA 92592-8592 |
Second Address | Temecula, CA 92592-2915 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/02/2022 |
Last Update Date | 02/02/2022 |