Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst | FL |
NPI | 1013420447 |
---|---|
Provider Name | Georgina Llanes |
First Address | Hialeah, FL 33014-4026 |
Second Address | Hialeah, FL 33014-4026 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/11/2017 |
Last Update Date | 07/11/2017 |