Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst | O215780943460 | FL |
NPI | 1063956829 |
---|---|
Provider Name | Steven Ospina |
First Address | Stuart, FL 34997-6826 |
Second Address | Orlando, FL 32812-7610 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/12/2016 |
Last Update Date | 14/12/2016 |