Taylor Dawn Simmons

Individual provider Active NPI Behavior Technician · Bloomfield, NM

NPI 1194353045 · NPPES record last updated Mar 27, 2020

Key facts

NPI
1194353045
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
416 E Broadway Ave
Bloomfield, NM 87413-6240
Phone
(505) 635-9920
NPI assigned
Mar 27, 2020
Sex
Female
Sole proprietor
No

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

416 E Broadway Ave
Bloomfield, NM 87413-6240

Mailing address

416 E Broadway Ave
Bloomfield, NM 87413-6240
Phone (505) 635-9920

Other providers in Bloomfield, NM

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

Sources for this page

Verify at the official NPI Registry.