Individual
MRS. MARYSE IMBERT ISMA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2425 DEN ST, SAINT AUGUSTINE, FL 32092-3636
(954) 649-0800
Mailing address
2425 DEN ST, SAINT AUGUSTINE, FL 32092-3636
(954) 649-0800
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
ISW11093
FL
Other
Enumeration date
12/16/2018
Last updated
12/16/2018
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