Individual
LILINE NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BEHAVIOR HEALTH
Contact information
Practice address
2604 NW 3RD AVE APT 227, WILTON MANORS, FL 33311-3047
(954) 240-9324
Mailing address
2604 NW 3RD AVE APT 227, WILTON MANORS, FL 33311-3047
(954) 240-9324
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9437850356
—
FL
Enumeration date
08/28/2018
Last updated
08/28/2018
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