Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician |
NPI | 1003322769 |
---|---|
Provider Name | Megan Kinsley |
First Address | Orlando, FL 32810-5915 |
Second Address | Orlando, FL 32810-5915 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/12/2017 |
Last Update Date | 18/12/2017 |