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General NPI Number Information
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NPI Number | 1992286769
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Entity Type | Individual
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Provider Name | AASHILD RENEE NILSSEN RBT
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Gender | Female
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Dates
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Enumeration Date | 08/28/2018
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Last Update Date | 07/13/2019
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Provider Practice Location Address
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Address Line | 90 STATE STREET SUITE 700
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City | ALBANY
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State | NY
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Zip | 12207
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Country | US
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Telephone | 631-385-7780
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Fax | 631-385-7795
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Provider Business Mailing Address
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Address Line | 90 STATE STREET SUITE 700
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City | ALBANY
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State | NY
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Zip | 12207
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Country | US
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Telephone | 631-385-7780
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Fax | 631-385-7795
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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-18-63359
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License Number State | UT
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