Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103K00000X | Behavior Analyst | FL | |
Y | 106S00000X | Behavior Technician |
NPI | 1003335530 |
---|---|
Provider Name | Roberto Cancio |
First Address | Miami, FL 33174-1651 |
Second Address | Miami, FL 33186-5331 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/09/2017 |
Last Update Date | 20/09/2017 |