Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103K00000X | Behavior Analyst | CA | |
Y | 106S00000X | Behavior Technician |
NPI | 1003581752 |
---|---|
Provider Name | Karina Lucia Gonzalez |
First Address | Deerfield Beach, FL 33441-1817 |
Second Address | Stockton, CA 95207-8107 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/08/2021 |
Last Update Date | 13/08/2021 |