Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst |
NPI | 1093250516 |
---|---|
Provider Name | Evana Abraham |
First Address | Tampa, FL 33610-5000 |
Second Address | Tampa, FL 33610-5000 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/12/2016 |
Last Update Date | 30/08/2019 |