Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst | 0-16-7344 | FL |
NPI | 1164974952 |
---|---|
Provider Name | Alexandra Christina Perez |
First Address | Davie, FL 33324-6848 |
Second Address | Pompano Beach, FL 33069-5391 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/10/2016 |
Last Update Date | 27/10/2016 |