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General NPI Number Information
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NPI Number | 1043901663
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Entity Type | Individual
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Provider Name | ANGELA KAY TUBBS
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Gender | Female
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Dates
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Enumeration Date | 05/16/2023
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Last Update Date | 05/16/2023
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Provider Practice Location Address
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Address Line | 516 W US HIGHWAY 24
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City | GOODLAND
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State | KS
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Zip | 67735-9658
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Country | US
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Telephone | 785-772-1583
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Fax |
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Provider Business Mailing Address
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Address Line | 6214 24TH AVE
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City | BROOKLYN
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State | NY
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Zip | 11204-3319
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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