Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst |
NPI | 1003112293 |
---|---|
Provider Name | Stephen P Lauver-Simmons |
First Address | Lebanon, PA 17046-5040 |
Second Address | Gettysburg, PA 17325-1930 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/02/2011 |
Last Update Date | 04/02/2011 |