Tiffany Birdsong-Hatnot
Individual provider Active NPI Behavior Technician · Universal City, TX
NPI 1821861667 · NPPES record last updated Nov 2, 2023
Key facts
- NPI
- 1821861667
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- License
- RBT-23-308459 (TX)
- Practice address
- 932 Coronado Blvd
Universal City, TX 78148-3227 - Phone
- (847) 465-9556
- NPI assigned
- Nov 2, 2023
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
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-23-308459 | TX | MD | Behavior Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Funtastic Gymnastic LLC | Behavior Technician | Current |
Accepting new patients |
Locations
991 Oak Creek Dr
Lombard, IL 60148
Phone (312) 882-5237
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | RBT-23-308459 | TX | Yes |
Addresses
Primary practice location
932 Coronado Blvd
Universal City, TX 78148-3227
Mailing address
991 Oak Creek Dr
Lombard, IL 60148-6408
Other providers in Universal City, TX
- Amber Beck
- Sharyn H Bell
- Teresa Wilburn Bethany
- Tiffany Beverly
- Nicholas Bialobos
- Blue Zone Therapy PLLC
- Bocalingual Speech Therapy LLC
- Mary Bohannon
- Patricia Ann Born
- Randall S Braddock
All providers in Universal City, TX · Behavior Technician in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 2, 2023. 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.