Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst |
NPI | 1114411980 |
---|---|
Provider Name | Beth Nicole Giguere |
First Address | St. Petersburg, FL 33714 |
Second Address | St Petersburg, FL 33703-5021 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2018 |
Last Update Date | 18/01/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100007200 | (05) | FL |