Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 106S00000X | Behavior Technician | ||
Y | 106S00000X | Behavior Technician | RBT-21-185869 | FL |
NPI | 1003406026 |
---|---|
Provider Name | Kayla Oberkfell |
First Address | Casselberry, FL 32707-5372 |
Second Address | Casselberry, FL 32707-5372 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/01/2021 |
Last Update Date | 26/09/2021 |