Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | 1-14-0834 | CA |
NPI | 1013306935 |
---|---|
Provider Name | Timothy Ohara |
First Address | Citrus Heights, CA 95621-1741 |
Second Address | Citrus Heights, CA 95621-1741 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/01/2015 |
Last Update Date | 15/01/2015 |