Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst |
NPI | 1134650914 |
---|---|
Provider Name | Ileana Alvarez Caballero |
First Address | Cutler Bay, FL 33189-3087 |
Second Address | Cutler Bay, FL 33189-3966 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2017 |
Last Update Date | 21/07/2021 |