Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician |
NPI | 1003392804 |
---|---|
Provider Name | Joshua Joel Eite |
First Address | Stuart, FL 34997-6826 |
Second Address | Fort Lauderdale, FL 33309-1947 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2018 |
Last Update Date | 14/07/2018 |