Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst |
NPI | 1083255913 |
---|---|
Provider Name | Jailyn Castro Garcia |
First Address | Stuart, FL 34997-7462 |
Second Address | West Palm Beach, FL 33409-6447 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2019 |
Last Update Date | 02/10/2019 |