Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | 1-20-41716 | |
N | 106E00000X | Assistant Behavior Analyst | 0-18-9045 | FL |
NPI | 1114402898 |
---|---|
Provider Name | Elida Evelyn Gil |
First Address | Miami, FL 33169-6525 |
Second Address | Miami, FL 33169-6525 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/09/2018 |
Last Update Date | 04/03/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
020652300 | (05) | FL |