Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103K00000X | Behavior Analyst | ||
Y | 103K00000X | Behavior Analyst | 12156730 | FL |
N | 106E00000X | Assistant Behavior Analyst | 02112691 | |
N | 106S00000X | Behavior Technician | 20112993 | FL |
NPI | 1114697323 |
---|---|
Provider Name | Lisandra Comas Roldan |
First Address | Miami, FL 33182-2431 |
Second Address | Miami, FL 33182-2431 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/09/2021 |
Last Update Date | 03/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
109481900 | (05) | FL |