Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst | 0-21-12885 | FL |
N | 106S00000X | Behavior Technician |
NPI | 1114584364 |
---|---|
Provider Name | Dario Borrego |
First Address | Hialeah, FL 33010-5413 |
Second Address | Hialeah, FL 33010-5413 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2019 |
Last Update Date | 01/11/2021 |