Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician | RBT-20-115821 | FL |
NPI | 1003380403 |
---|---|
Provider Name | Laila Dumas |
First Address | Lake Worth, FL 33467-8748 |
Second Address | Palm City, FL 34990-1747 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/01/2019 |
Last Update Date | 09/02/2021 |