Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | 2282079 | NY |
NPI | 1003179904 |
---|---|
Provider Name | Yndira Acosta |
First Address | Bronx, NY 10453-3344 |
Second Address | Brooklyn, NY 11235-3979 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2012 |
Last Update Date | 17/06/2012 |