Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician |
NPI | 1003358557 |
---|---|
Provider Name | Dianelys Navea Machado |
First Address | Hialeah, FL 33013-1428 |
Second Address | Hialeah, FL 33013-1428 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/11/2016 |
Last Update Date | 15/11/2016 |