Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst | 0-21-11934 | FL |
N | 106S00000X | Behavior Technician | 18-67268 | FL |
NPI | 1164078804 |
---|---|
Provider Name | Dora Maria Artiles Lopez |
First Address | Cutler Bay, FL 33190-1472 |
Second Address | Homestead, FL 33032-8219 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2019 |
Last Update Date | 06/04/2021 |