Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | ||
N | 106E00000X | Assistant Behavior Analyst | FL |
NPI | 1114436029 |
---|---|
Provider Name | Jaymee Ann Sambo Simbulan |
First Address | Orlando, FL 32835-5135 |
Second Address | Orlando, FL 32835-6317 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/09/2017 |
Last Update Date | 21/03/2018 |