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General NPI Number Information
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NPI Number | 1902495682
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Entity Type | Individual
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Provider Name | YANELI LICET RICO
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Gender | Female
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Dates
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Enumeration Date | 01/15/2021
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Last Update Date | 12/04/2024
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Provider Practice Location Address
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Address Line | 12031 TEXAS 151 ACCESS RD
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City | SAN ANTONIO
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State | TX
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Zip | 78251
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Country | US
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Telephone | 210-775-2222
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Fax |
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Provider Business Mailing Address
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Address Line | 117 MARIA DR
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City | PETALUMA
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State | CA
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Zip | 94954-3647
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Country | US
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Telephone | 707-696-1995
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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 | RBT20119991
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | RBT20119991
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-24-77419
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License Number State | TX
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