Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician | BACB434617 | FL |
NPI | 1003305210 |
---|---|
Provider Name | Naidaisy Martinez |
First Address | Hialeah, FL 33010-4953 |
Second Address | Hialeah, FL 33010-4953 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/05/2018 |
Last Update Date | 02/05/2018 |