| NPI | 1821521899 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROLIN ROSE FREDERICK Owner 863-602-8199 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 1-16-22830) |
| Enumeration Date | 2017-04-06 |
| Last Update Date | 2017-04-06 |