Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst |
NPI | 1003328832 |
---|---|
Provider Name | Taylor Alexis Whitey |
First Address | Naples, FL 34120-5225 |
Second Address | Stuart, FL 34997-6826 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/11/2017 |
Last Update Date | 02/11/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
019331500 | (05) | FL |