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Individual
TAYLA LOUISE PENOVICH
Active
Individual
TAYLA LOUISE PENOVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-19-38143
FL
103K00000X
Behavior Analyst
RBT-16-16125
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102465000
—
FL
Enumeration date
04/27/2018
Last updated
12/04/2020
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