Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst | ZZ |
NPI | 1174050900 |
---|---|
Provider Name | Miss Estefania Alarcon |
First Address | Melbourne, FL 32901-8945 |
Second Address | Melbourne, FL 32901-6982 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2017 |
Last Update Date | 11/05/2017 |