Jenifer Barreras-Kirk

Individual provider Active NPI Behavior Technician · Gallup, NM

NPI 1902409600 · NPPES record last updated Nov 17, 2020

Key facts

NPI
1902409600
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
3303 Church Rock St
Gallup, NM 87301-4505
Phone
(505) 870-5315
NPI assigned
Nov 17, 2020
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)CodeLicenseStatePrimary
Behavior Technician 106S00000X Yes

Addresses

Primary practice location

3303 Church Rock St
Gallup, NM 87301-4505

Mailing address

3303 Church Rock St
Gallup, NM 87301-4505

Other providers in Gallup, NM

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

Sources for this page

Verify at the official NPI Registry.