Mytyl Renee Salazar
Individual provider Active NPI Behavior Technician · Capitan, NM
NPI 1639681380 · NPPES record last updated Nov 2, 2017
Key facts
- NPI
- 1639681380
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- Practice address
- 102 S. Nogal Ave.
Capitan, NM 88316-0611 - Phone
- (575) 937-9193
- NPI assigned
- Nov 2, 2017
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Yes |
Addresses
Primary practice location
102 S. Nogal Ave.
Capitan, NM 88316-0611
Mailing address
PO Box 611
Capitan, NM 88316
Phone (575) 937-9193
Other providers in Capitan, NM
- Melissa Lynn Marlin
- David Michael Martinez
- Linda Rae Owen
- Lindsey Marie Patton
- Christina Reynolds
- Scheryiah J Southard
- Thomas Vansant
All providers in Capitan, NM · Behavior Technician in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 2, 2017. 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.