Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 106S00000X | Behavior Technician | FL | |
Y | 106S00000X | Behavior Technician | 20-120104 | FL |
NPI | 1003380858 |
---|---|
Provider Name | Evelin Mendez Osorio |
First Address | Hialeah, FL 33012-2335 |
Second Address | Hialeah, FL 33012-2335 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/01/2019 |
Last Update Date | 01/09/2021 |