Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | 1-17-26633 | FL |
N | 106E00000X | Assistant Behavior Analyst | 0-16-7517 | FL |
NPI | 1144765058 |
---|---|
Provider Name | Madison Pluto |
First Address | Fort Myers, FL 33913-6768 |
Second Address | Fort Myers, FL 33913-6768 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/12/2016 |
Last Update Date | 08/09/2021 |