Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst |
NPI | 1073164364 |
---|---|
Provider Name | Alejandra Jimenez |
First Address | Orlando, FL 32810-5915 |
Second Address | Orlando, FL 32810-5915 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/09/2019 |
Last Update Date | 27/09/2019 |