Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst |
NPI | 1003339425 |
---|---|
Provider Name | Leicy B Rodriguez Rodriguez |
First Address | Miami, FL 33144-4273 |
Second Address | Miami, FL 33144-4273 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2017 |
Last Update Date | 26/07/2017 |