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Individual
MR. ROGER SMITH JR.
Active
Individual
MR. ROGER SMITH JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RBT
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-17-40349
CA
Other
Enumeration date
10/04/2017
Last updated
10/04/2017
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