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General NPI Number Information
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NPI Number | 1982166252
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Entity Type | Individual
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Provider Name | NATHALIE REYES RICO
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Gender | Female
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Dates
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Enumeration Date | 04/04/2019
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Last Update Date | 04/04/2019
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Provider Practice Location Address
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Address Line | 23504 LYONS AVE STE 304A
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City | SANTA CLARITA
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State | CA
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Zip | 91321-5776
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Country | US
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Telephone | 661-702-0166
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Fax |
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Provider Business Mailing Address
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Address Line | 2617 GOLDENRAIN ST
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City | PALMDALE
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State | CA
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Zip | 93551-6116
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Country | US
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Telephone | 661-547-7608
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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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