Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 106E00000X | Assistant Behavior Analyst | 0-19-10066 | |
Y | 106S00000X | Behavior Technician | RBT-17-44213 | FL |
NPI | 1003310731 |
---|---|
Provider Name | Audreanna Poitier |
First Address | Kissimmee, FL 34759-5580 |
Second Address | Casselberry, FL 32707 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/03/2018 |
Last Update Date | 16/06/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
021142900 | (05) | FL |