Tyani Aguiar

Individual provider Active NPI Behavior Technician · Gresham, OR

NPI 1457931404 · NPPES record last updated Apr 13, 2021

Key facts

NPI
1457931404
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
License
A700521 (OR)
Practice address
912 NE Kelly Ave # 100C
Gresham, OR 97030-5629
Phone
(550) 350-3912
NPI assigned
Apr 13, 2021
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

State licenses

LicenseStateTypeSpecialty
A700521ORMDBehavior Technician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X A700521 OR Yes

Addresses

Primary practice location

912 NE Kelly Ave # 100C
Gresham, OR 97030-5629

Mailing address

21600 Oxnard St Ste 1800
Woodland Hills, CA 91367-7807
Phone (818) 345-2345

Other providers in Gresham, OR

All providers in Gresham, OR · Behavior Technician in Oregon

Sources for this page

Verify at the official NPI Registry.