Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | BCBA-1-21-53843 | FL |
N | 106E00000X | Assistant Behavior Analyst | 0-18-8479 | FL |
NPI | 1003263930 |
---|---|
Provider Name | Sergio Silva SR. |
First Address | Miami, FL 33132-3235 |
Second Address | Miami, FL 33185-3827 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/05/2016 |
Last Update Date | 26/10/2021 |