Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | 1-20-44913 | FL |
N | 106E00000X | Assistant Behavior Analyst | BCABA-0-19-10568 | FL |
NPI | 1154955763 |
---|---|
Provider Name | Yessika Boada Hung |
First Address | Miami, FL 33176-4575 |
Second Address | Miami, FL 33176-4575 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/02/2020 |
Last Update Date | 05/10/2020 |