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General NPI Number Information
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NPI Number | 1093680753
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Entity Type | Individual
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Provider Name | ROSE AMY RIVERA GAGLIASTRO
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Gender | Female
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Dates
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Enumeration Date | 10/10/2025
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Last Update Date | 10/10/2025
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Provider Practice Location Address
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Address Line | 2300 CLEAR CREEK RD STE 300
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City | KILLEEN
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State | TX
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Zip | 76549-4984
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Country | US
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Telephone | 254-768-2112
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Fax | 254-768-2106
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Provider Business Mailing Address
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Address Line | 4407 CAPTAIN DR
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City | KILLEEN
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State | TX
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Zip | 76549-3103
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Country | US
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Telephone | 254-768-2112
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Fax | 254-768-2106
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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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