Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst |
NPI | 1104361278 |
---|---|
Provider Name | Seidel Segura |
First Address | Miami, FL 33133-5604 |
Second Address | Miami, FL 33133-5604 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/12/2016 |
Last Update Date | 06/01/2017 |