Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | 12154268 | FL |
N | 106E00000X | Assistant Behavior Analyst | 0-21-12078 | FL |
NPI | 1093481830 |
---|---|
Provider Name | Mercedes Sanchez Campano |
First Address | Miami, FL 33156-7948 |
Second Address | Miami, FL 33186-4215 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/08/2021 |
Last Update Date | 15/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
103495500 | (05) | FL |