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Individual
FANMY VEGA ROMAN
Active
Individual
FANMY VEGA ROMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-20-43957
FL
106S00000X
Behavior Technician
17-32544
FL
247200000X
Other Technician
V265-40-87-625-0
FL
Other
Enumeration date
06/29/2016
Last updated
08/21/2020
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