Tatiana Michelle Gonzalez

Individual provider Active NPI Behavior Technician · Anchorage, AK

NPI 1861909418 · NPPES record last updated Jan 4, 2018

Key facts

NPI
1861909418
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
License
RBT-17-45171 (AK)
Practice address
2836 Kimberlie CT
Anchorage, AK 99508-5329
Phone
(907) 349-4222
NPI assigned
Jan 4, 2018
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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
RBT-17-45171AKMDBehavior Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Early Learning for Everyone Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X RBT-17-45171 AK Yes

Addresses

Primary practice location

2836 Kimberlie CT
Anchorage, AK 99508-5329

Mailing address

5340 E 26TH Ave
Anchorage, AK 99508-3851

Other providers in Anchorage, AK

All providers in Anchorage, AK · Behavior Technician in Alaska

Sources for this page

Verify at the official NPI Registry.