Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician |
NPI | 1003394941 |
---|---|
Provider Name | Alexas Thomas |
First Address | Cocoa, FL 32927-5216 |
Second Address | Cocoa, FL 32927-5216 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/08/2018 |
Last Update Date | 04/05/2021 |