Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103K00000X | Behavior Analyst | ||
Y | 106S00000X | Behavior Technician |
NPI | 1003349622 |
---|---|
Provider Name | Ariel Vazquez |
First Address | Hialeah, FL 33014-4400 |
Second Address | Hialeah, FL 33014-4400 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2017 |
Last Update Date | 23/10/2017 |