Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | 1-04-2029 | FL |
NPI | 1003332743 |
---|---|
Provider Name | Mrs. Shawanda Wright |
First Address | Orlando, FL 32835-5760 |
Second Address | Orlando, FL 32835 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/08/2017 |
Last Update Date | 15/08/2017 |