Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician |
NPI | 1003389453 |
---|---|
Provider Name | Treanna Brown |
First Address | Dublin, CA 94568-2796 |
Second Address | Dublin, CA 94568-2796 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/01/2019 |
Last Update Date | 08/01/2019 |