Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst | ||
N | 106S00000X | Behavior Technician |
NPI | 1053821280 |
---|---|
Provider Name | Mairelys Diaz |
First Address | Miami, FL 33125-2862 |
Second Address | Miami, FL 33125-2862 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2017 |
Last Update Date | 30/08/2021 |