Shayla Wilson
Individual provider Active NPI Behavior Technician · Hatch, NM
NPI 1902475262 · NPPES record last updated Jun 23, 2021
Key facts
- NPI
- 1902475262
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- Practice address
- 995 E. Hall Street
Hatch, NM 87937 - Phone
- (575) 693-1291
- NPI assigned
- Jun 22, 2021
- 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
995 E. Hall Street
Hatch, NM 87937
Mailing address
995 E. Hall Street
Hatch, NM 87937
Other providers in Hatch, NM
All providers in Hatch, 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 Jun 23, 2021. 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.