Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst | 0-21-13375 | FL |
NPI | 1134771306 |
---|---|
Provider Name | Nalvis Machado Legra |
First Address | Hialeah, FL 33015-5449 |
Second Address | Hialeah, FL 33015-5449 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/07/2019 |
Last Update Date | 30/12/2021 |