Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | 1257 | FL |
N | 103TS0200X | School Psychologist | 1257 | FL |
NPI | 1013475839 |
---|---|
Provider Name | Ms. Adriana Guimaraes |
First Address | Stuart, FL 34997-7462 |
Second Address | West Palm Beach, FL 33409-6447 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/03/2019 |
Last Update Date | 28/03/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1257 | STATE OF FLORIDA HEALTH DEPARTMENT (01) | FL |