Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician |
NPI | 1003427436 |
---|---|
Provider Name | Wenddy Lino |
First Address | Clovis, CA 93612-4377 |
Second Address | Clovis, CA 93612-4377 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2020 |
Last Update Date | 10/08/2020 |