Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst |
NPI | 1053880369 |
---|---|
Provider Name | Thomas Albert Mury |
First Address | Lake Mary, FL 32746-3625 |
Second Address | Ocala, FL 34471-9105 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/11/2018 |
Last Update Date | 30/09/2020 |