Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst | 0-17-8251 | FL |
NPI | 1154676740 |
---|---|
Provider Name | Israel Soto |
First Address | Doral, FL 33172-1416 |
Second Address | Doral, FL 33172-1416 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2012 |
Last Update Date | 18/09/2019 |