Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst |
NPI | 1003481094 |
---|---|
Provider Name | Kendall Patricia Dary |
First Address | Jacksonville, FL 32256-7196 |
Second Address | Jacksonville, FL 32256-4447 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2021 |
Last Update Date | 23/05/2021 |