Lani Tyler

Individual provider Active NPI Behavior Technician · Tijeras, NM

NPI 1083201701 · NPPES record last updated Dec 29, 2020

Key facts

NPI
1083201701
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
49 Camino del Poniente
Tijeras, NM 87059-7409
Phone
(505) 750-4475
NPI assigned
Dec 29, 2020
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Yes

Addresses

Primary practice location

49 Camino del Poniente
Tijeras, NM 87059-7409

Mailing address

49 Camino del Poniente
Tijeras, NM 87059-7409

Other providers in Tijeras, NM

All providers in Tijeras, NM · Behavior Technician in New Mexico

Sources for this page

Verify at the official NPI Registry.