Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst |
NPI | 1164965075 |
---|---|
Provider Name | Victor Evins |
First Address | Palm Beach Gardens, FL 33403-1606 |
Second Address | Palm Beach Gardens, FL 33403-1606 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/11/2016 |
Last Update Date | 25/11/2016 |