Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician |
NPI | 1003387606 |
---|---|
Provider Name | Tiffany Towle |
First Address | Pleasanton, CA 94588-3347 |
Second Address | Stockton, CA 95207-8107 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/12/2018 |
Last Update Date | 08/12/2018 |