Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | 1-18-33323 | FL |
N | 106E00000X | Assistant Behavior Analyst |
NPI | 1023465937 |
---|---|
Provider Name | Liuba M Lopez Castellanos |
First Address | Hialeah, FL 33013-2847 |
Second Address | Hialeah, FL 33013-2847 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/05/2016 |
Last Update Date | 19/02/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
017510600 | (05) | FL |