Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | FL |
NPI | 1003213398 |
---|---|
Provider Name | Tatiana Pereira |
First Address | Doral, FL 33166-6556 |
Second Address | Doral, FL 33166-6556 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/12/2014 |
Last Update Date | 02/12/2014 |