Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst | RBT1976212 | FL |
NPI | 1093366429 |
---|---|
Provider Name | Ms. Mauria Maria Hernandez |
First Address | Doral, FL 33166-6533 |
Second Address | Doral, FL 33166-6533 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/09/2019 |
Last Update Date | 26/09/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H65555383687 | LICENSE (01) |