Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103K00000X | Behavior Analyst | ||
N | 106E00000X | Assistant Behavior Analyst | ||
Y | 106S00000X | Behavior Technician |
NPI | 1073285383 |
---|---|
Provider Name | Genesis Reyes |
First Address | Lake Mary, FL 32746-5028 |
Second Address | Gainesville, FL 32605-4481 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2021 |
Last Update Date | 05/10/2021 |