Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TB0200X | Cognitive & Behavioral Psychologist | 020899400 | FL |
Y | 106S00000X | Behavior Technician |
NPI | 1164935607 |
---|---|
Provider Name | Maria Ines Aguilar |
First Address | West Miami, FL 33144-5604 |
Second Address | Miami, FL 33172-4511 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/11/2017 |
Last Update Date | 29/11/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
020899400 | (05) | FL |