Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician |
NPI | 1003306069 |
---|---|
Provider Name | Estela Niubo-Rodriguez |
First Address | Ft Lauderdale, FL 33301-1876 |
Second Address | Ft Lauderdale, FL 33301-1876 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2018 |
Last Update Date | 15/05/2018 |