Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | 1-21-53516 | |
N | 106E00000X | Assistant Behavior Analyst | 0-18-8851 | FL |
NPI | 1073965877 |
---|---|
Provider Name | Marta I Hernandez Regalado |
First Address | Miami Gardens, FL 33055-1137 |
Second Address | Miami Gardens, FL 33055-1137 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2016 |
Last Update Date | 24/09/2021 |