Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst | 0-21-11960 | FL |
NPI | 1063174704 |
---|---|
Provider Name | Elena Diaz Alvarez |
First Address | Miami, FL 33172-5545 |
Second Address | Miami, FL 33172-5545 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/10/2021 |
Last Update Date | 11/10/2021 |