Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | 0133000902 | VA |
N | 103K00000X | Behavior Analyst | LBA291 | MD |
NPI | 1003351354 |
---|---|
Provider Name | Tiffany Danielle Bridgers |
First Address | Coral Gables, FL 33134-4108 |
Second Address | Coral Gables, FL 33134-4108 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/12/2016 |
Last Update Date | 20/10/2021 |