Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician | FL |
NPI | 1003305582 |
---|---|
Provider Name | Leisbet Reina Alvarez Laurenti |
First Address | Hialeah, FL 33016-3973 |
Second Address | Miami, FL 33172-7018 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/05/2018 |
Last Update Date | 09/05/2018 |