Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst | ||
N | 106S00000X | Behavior Technician | RBT-18-65928 | FL |
NPI | 1083131577 |
---|---|
Provider Name | Rosa Acosta Iglesias |
First Address | Hialeah, FL 33013-3372 |
Second Address | Hialeah, FL 33013-3372 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/08/2017 |
Last Update Date | 21/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
104180300 | (05) | FL |