NPI | 1619220498 |
---|---|
Former Name | JOHANNA IVETTE SANTOS RIVERA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 1-17-28059) |
Additional Taxonomies | 103K00000X Behavior Analyst (Licence: CA 1-17-28059) |
101YP2500X Counselor, Professional (Licence: TX 66582) | |
Enumeration Date | 2012-10-18 |
Last Update Date | 2024-11-13 |