Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103K00000X | Behavior Analyst |
NPI | 1003176181 |
---|---|
Provider Name | Stephanie Rose Cummings |
First Address | Fort Lauderdale, FL 33316-6004 |
Second Address | Fort Lauderdale, FL 33316-6004 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2012 |
Last Update Date | 21/07/2016 |