Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician | RBT-20-120949 | FL |
NPI | 1003424714 |
---|---|
Provider Name | Omaida Niebla Munoz |
First Address | Miami, FL 33142-2851 |
Second Address | Miami, FL 33142-2851 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2020 |
Last Update Date | 20/07/2020 |