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Individual
KAYLON V MALLARD
Active
Individual
KAYLON V MALLARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RBT
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
018717800
—
FL
Enumeration date
07/19/2019
Last updated
07/19/2019
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