Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | ||
N | 106E00000X | Assistant Behavior Analyst |
NPI | 1093251530 |
---|---|
Provider Name | Katherine Sotolongo |
First Address | Largo, FL 33771-2866 |
Second Address | Tampa, FL 33619-7863 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/01/2017 |
Last Update Date | 07/10/2020 |