Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | B 5020 | FL |
Y | 103K00000X | Behavior Analyst | B 5020 | FL |
NPI | 1003043142 |
---|---|
Provider Name | Dr. William Alexander Edmonds |
First Address | North Miami Beach, FL 33160-0568 |
Second Address | North Miami Beach, FL 33162-3017 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2009 |
Last Update Date | 16/06/2009 |