Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103K00000X | Behavior Analyst | 1-11-8006 | FL |
Y | 103TC2200X | Clinical Child & Adolescent Psychologist | PY8731 | FL |
NPI | 1114226974 |
---|---|
Provider Name | Parastoo F. Nabizadeh |
First Address | Jacksonville, FL 32216-1700 |
Second Address | Jacksonville, FL 32216-1700 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/03/2011 |
Last Update Date | 08/04/2013 |