Bianca Al-Tahan

Individual provider Active NPI Behavior Technician · Anthony, NM

NPI 1871075556 · NPPES record last updated Mar 18, 2025

Key facts

NPI
1871075556
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
785 Anthony Drive
Anthony, NM 88021-2671
Phone
(575) 882-5100
NPI assigned
Aug 30, 2018
Sex
Female
Sole proprietor
No

Organizations & group practices 2

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

Practice roles

OrganizationSpecialtyStatusNew patients
Amanecer Community Counseling Center, LLC Past Accepting new patients
Amanecer Community Counseling Center Past
since Feb 27, 2017
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Yes

Addresses

Primary practice location

785 Anthony Drive
Anthony, NM 88021-2671

Mailing address

PO Box 2671
Anthony, NM 88021-2671
Phone (575) 882-5100

Other identifiers

IdentifierTypeStateIssuer
35650338MedicaidNM

Other providers in Anthony, NM

All providers in Anthony, NM · Behavior Technician in New Mexico

Sources for this page

Verify at the official NPI Registry.