Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst |
NPI | 1003339326 |
---|---|
Provider Name | Sussel Bueno Santana |
First Address | Doral, FL 33122-1075 |
Second Address | Doral, FL 33122-1075 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2017 |
Last Update Date | 18/07/2017 |