Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 106S00000X | Behavior Technician | RBT-15-08095 | FL |
NPI | 1003306622 |
---|---|
Provider Name | Roxana Morejon |
First Address | Miami Gardens, FL 33055-4702 |
Second Address | Miami Gardens, FL 33055-4702 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2018 |
Last Update Date | 14/05/2021 |