Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | 1-19-40459 | |
N | 106E00000X | Assistant Behavior Analyst | 0-18-8789 | FL |
N | 106S00000X | Behavior Technician | RBT-17-37819 | FL |
NPI | 1063902930 |
---|---|
Provider Name | Syntha Alvarez |
First Address | Marianna, FL 32446-1877 |
Second Address | Marianna, FL 32446 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2018 |
Last Update Date | 11/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
023051600 | (05) | FL |
1-19-40459 | BEHAVIOR ANALYSIS CERTIFICATION BOARD (01) |