Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst | 0-21-12543 | FL |
NPI | 1164192969 |
---|---|
Provider Name | Ariel Andre Lauries |
First Address | Miami, FL 33165-7638 |
Second Address | Miami, FL 33165-7638 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/09/2021 |
Last Update Date | 18/10/2021 |