Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst |
NPI | 1003380692 |
---|---|
Provider Name | Eidy Marie Montero-Natal |
First Address | Pinellas Park, FL 33780-0832 |
Second Address | Zephyrhills, FL 33542-5744 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/01/2019 |
Last Update Date | 16/01/2019 |