Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician |
NPI | 1003319021 |
---|---|
Provider Name | Alexa Marie Giolito |
First Address | Winter Garden, FL 34787-5732 |
Second Address | Casselberry, FL 32707-5372 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/03/2018 |
Last Update Date | 04/01/2019 |