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Individual
MISS LOURDES DIAZ REYES
Active
Individual
MISS LOURDES DIAZ REYES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-14-16542
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003720300
—
FL
Enumeration date
09/27/2010
Last updated
11/03/2014
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