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General NPI Number Information
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NPI Number | 1902689268
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Entity Type | Individual
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Provider Name | TERRI JEAN SLICK RBT
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Gender | Female
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Dates
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Enumeration Date | 08/18/2023
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Last Update Date | 08/18/2023
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Provider Practice Location Address
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Address Line | 2400 ELLIS ST STE 1
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City | VENUS
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State | TX
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Zip | 76084-3390
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Country | US
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Telephone | 682-877-1234
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Fax |
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Provider Business Mailing Address
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Address Line | 100 E RIDGEWAY DR APT 107
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City | MIDLOTHIAN
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State | TX
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Zip | 76065-2122
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Country | US
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Telephone | 785-545-5407
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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 | RBT-21-177991
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License Number State |
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