Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst |
NPI | 1013451152 |
---|---|
Provider Name | Mr. Delroy A Mercurius |
First Address | North Lauderdale, FL 33068-2106 |
Second Address | North Lauderdale, FL 33068-2106 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/12/2016 |
Last Update Date | 08/12/2016 |