Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | 1-21-50087 | FL |
NPI | 1003165093 |
---|---|
Provider Name | Rebecca Louise Waddell |
First Address | Tampa, FL 33614-6824 |
Second Address | Tampa, FL 33614-6824 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/09/2012 |
Last Update Date | 10/06/2021 |