Samuel Thomas Dykstra
Behavior Technician in Reno, NV. Individual provider (NPI-1).
NPI number1629630751
StatusActive
Last updated in NPPESJun 28, 2019
Details
- NPI
- 1629630751
- Entity type
- Individual (NPI-1)
- Name
- Samuel Thomas Dykstra
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jun 28, 2019
- Last updated
- Jun 28, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | – | Yes |
Practice location
1101 W Moana Ln Ste 2Reno, NV 89509-4734
Phone 775-337-2394
Mailing address
1101 W Moana Ln Ste 2Reno, NV 89509-4734
Phone 775-337-2394
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