Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst |
NPI | 1003463761 |
---|---|
Provider Name | Lisbeydi Madrigal |
First Address | Boynton Beach, FL 33474-1236 |
Second Address | Lake Clarke Shores, FL 33406-6021 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/08/2019 |
Last Update Date | 19/08/2019 |