Alisia Michelle Bolin
Individual provider Active NPI Behavior Technician · Crestview, FL
NPI 1609373307 · NPPES record last updated Apr 9, 2018
Key facts
- NPI
- 1609373307
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- License
- RBT-18-53062 (FL)
- Practice address
- 851 N Wilson St
Crestview, FL 32536-2639 - Phone
- (850) 398-6021
- NPI assigned
- Apr 9, 2018
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-18-53062 | FL | MD | Behavior Technician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | RBT-18-53062 | FL | Yes |
Addresses
Primary practice location
851 N Wilson St
Crestview, FL 32536-2639
Mailing address
3771 Stefani Rd
Cantonment, FL 32533-7795
Phone (850) 398-6021
Other providers in Crestview, FL
- Connie Blount
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- Bluewater Orthopedics, P.a.
- Karey Boerst
- Tamara Bogle
- Emma Bombriant
- Amy Bondurant
- Robert Alan Bortz
- Marcello A Borzatta
- Emily Virginia Bowling
All providers in Crestview, FL · Behavior Technician in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 9, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.