Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst | 0-19-10011 | FL |
N | 106S00000X | Behavior Technician |
NPI | 1023553955 |
---|---|
Provider Name | Lacey Nicole Linaja |
First Address | Orlando, FL 32806-5764 |
Second Address | Orlando, FL 32837-8986 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/01/2017 |
Last Update Date | 10/09/2020 |