Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 106E00000X | Assistant Behavior Analyst | 0-21-12788 | |
Y | 106S00000X | Behavior Technician | 17-41044 | SC |
NPI | 1174021919 |
---|---|
Provider Name | Mirranda Figueroa |
First Address | Gaffney, SC 29340-5946 |
Second Address | Roebuck, SC 29376-3122 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/01/2018 |
Last Update Date | 19/10/2021 |