Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician | RBT-20-119924 | FL |
NPI | 1003420373 |
---|---|
Provider Name | Annelys Clara Garcia |
First Address | Miami, FL 33196-4686 |
Second Address | Miami, FL 33196-4686 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/09/2020 |
Last Update Date | 03/09/2020 |