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General NPI Number Information
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NPI Number | 1356260210
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Entity Type | Individual
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Provider Name | DAIZY M NEWBERN RBT
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Gender | Female
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Dates
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Enumeration Date | 07/14/2026
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Last Update Date | 07/14/2026
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Provider Practice Location Address
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Address Line | 3605 W SOUTHERN HILLS BLVD STE 100
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City | ROGERS
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State | AR
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Zip | 72758-8267
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Country | US
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Telephone | 479-278-7155
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Fax |
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Provider Business Mailing Address
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Address Line | 920 UNIVERSITY DR
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City | RUSSELLVILLE
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State | AR
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Zip | 72801-4303
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Country | US
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Telephone | 479-967-2322
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Fax | 479-763-3308
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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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