Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | 1-21-54160 | FL |
N | 106S00000X | Behavior Technician | 19-74860 | FL |
NPI | 1003382821 |
---|---|
Provider Name | Monica Gonzalez Molleda |
First Address | Miami, FL 33165-4005 |
Second Address | Miami, FL 33165-4005 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/10/2018 |
Last Update Date | 28/01/2022 |