Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst |
NPI | 1134506017 |
---|---|
Provider Name | Khadija Mccarthy |
First Address | Miramar, FL 33025-7590 |
Second Address | Miami, FL 33193-5827 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/04/2015 |
Last Update Date | 21/05/2019 |