Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst | 0-20-11299 | FL |
NPI | 1063182178 |
---|---|
Provider Name | Dainarys Reyes Martinez |
First Address | Miami, FL 33177-3110 |
Second Address | Miami, FL 33177-3110 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2021 |
Last Update Date | 20/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0-20-11299 | (05) | FL |