Individual
EUSELIS LEON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
18936 NW 57TH AVE APT 202, HIALEAH, FL 33015-7067
(786) 709-6994
Mailing address
18936 NW 57TH AVE APT 202, HIALEAH, FL 33015-7067
(786) 709-6994
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
0-24-15441
FL
106S00000X
Behavior Technician
RBT1988559
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
105297400
—
FL
Enumeration date
08/05/2020
Last updated
09/06/2024
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