Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst | FL |
NPI | 1104332154 |
---|---|
Provider Name | Mary Scholz |
First Address | Orlando, FL 32828-8163 |
Second Address | Casselberry, FL 32707-5372 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/12/2017 |
Last Update Date | 28/12/2017 |