Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst | BCABA0189179 | FL |
NPI | 1023468451 |
---|---|
Provider Name | Yovani Rivas Gomez |
First Address | Miami, FL 33196-3543 |
Second Address | Miami, FL 33196-3543 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2016 |
Last Update Date | 08/10/2018 |