Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst | 0-21-11750 | FL |
NPI | 1073025433 |
---|---|
Provider Name | Yilian Isora Mastrapa |
First Address | Royal Palm Beach, FL 33411-1271 |
Second Address | Boca Raton, FL 33431-5188 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2017 |
Last Update Date | 27/01/2021 |