Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103K00000X | Behavior Analyst |
NPI | 1003294778 |
---|---|
Provider Name | Madison Plummer |
First Address | New Port Richey, FL 34652 |
Second Address | New Port Richey, FL 34652 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/05/2015 |
Last Update Date | 30/06/2020 |