Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst | 0-19-10183 | FL |
NPI | 1033562491 |
---|---|
Provider Name | Olga L Mendez Carmona |
First Address | Hialeah, FL 33012-5144 |
Second Address | Hialeah, FL 33012-5144 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2016 |
Last Update Date | 17/10/2019 |