Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst |
NPI | 1053887281 |
---|---|
Provider Name | Iris Regueira Jacomino |
First Address | Miami, FL 33176-3319 |
Second Address | Miami, FL 33196-1584 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/10/2018 |
Last Update Date | 15/10/2018 |