Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TB0200X | Cognitive & Behavioral Psychologist |
NPI | 1245581859 |
---|---|
Provider Name | Virjen Sanchez |
First Address | Sunrise, FL 33351-8256 |
Second Address | Sunrise, FL 33325-6244 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/09/2012 |
Last Update Date | 21/09/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
650908151 | ABA (01) | FL |