Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst |
NPI | 1013459601 |
---|---|
Provider Name | Sasha Davis |
First Address | Palm Beach Gardens, FL 33403-1606 |
Second Address | Palm Beach Gardens, FL 33403-1606 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/11/2016 |
Last Update Date | 22/02/2017 |