Individual
ALICE JOHANIE MATIAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
736 BAYWOOD CIR, SANFORD, FL 32773-6206
(574) 327-0529
Mailing address
736 BAYWOOD CIR, SANFORD, FL 32773-6206
(574) 327-0529
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BACB-1-19-38899
FL
Other
Enumeration date
12/14/2016
Last updated
05/23/2024
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