Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst | 103K00000X | FL |
NPI | 1023553484 |
---|---|
Provider Name | Jayn Baker |
First Address | Miami, FL 33180-1668 |
Second Address | Miami, FL 33180-1668 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/12/2016 |
Last Update Date | 21/12/2016 |