Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst |
NPI | 1033648605 |
---|---|
Provider Name | Miguel Saucedo |
First Address | Homestead, FL 33033-4363 |
Second Address | Homestead, FL 33033-4363 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2017 |
Last Update Date | 06/09/2019 |