Individual provider · NPI-1

Rebecca Anne Bourque

Behavior Technician · Eagle River, AK

NPI number1730649203
StatusActive
Last updated in NPPESMar 21, 2019

Details

NPI
1730649203
Entity type
Individual (NPI-1)
Name
Rebecca Anne Bourque
Sex
Female
Sole proprietor
No
Enumeration date
Mar 21, 2019
Last updated
Mar 21, 2019

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
106S00000X Behavior Technician––Yes

Practice location

16941 N Eagle River Loop Rd Ste 3
Eagle River, AK 99577-7824

Phone 907-726-5330

Mailing address

16941 N Eagle River Loop Rd Ste 3
Eagle River, AK 99577-7824

Phone 907-726-5330

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