Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103K00000X | Behavior Analyst | ||
Y | 106E00000X | Assistant Behavior Analyst |
NPI | 1033622055 |
---|---|
Provider Name | Peyton Leighann Stipes |
First Address | Tampa, FL 33610-9712 |
Second Address | Tampa, FL 33610-9712 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/11/2017 |
Last Update Date | 15/03/2020 |