Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | RBT-18-66198 | FL |
NPI | 1003462805 |
---|---|
Provider Name | Ana Isabel Quintanal |
First Address | Miami, FL 33174-2333 |
Second Address | Doral, FL 33172-5927 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2019 |
Last Update Date | 16/08/2019 |