Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst | 0-17-7757 | FL |
NPI | 1013323260 |
---|---|
Provider Name | Felissa Faist |
First Address | Stuart, FL 34994-4591 |
Second Address | Stuart, FL 34994-4591 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/07/2014 |
Last Update Date | 10/04/2017 |