Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst | FL |
NPI | 1093297319 |
---|---|
Provider Name | Ana Luisa Rodriguez |
First Address | Kissimmee, FL 34744 |
Second Address | Kissimmee, FL 34741-3479 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/09/2018 |
Last Update Date | 04/09/2018 |