Kayla Dickerson
Behavior Technician in Antioch, CA. Individual provider (NPI-1).
NPI number1982201695
StatusActive
Last updated in NPPESOct 6, 2020
Details
- NPI
- 1982201695
- Entity type
- Individual (NPI-1)
- Name
- Kayla Dickerson
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Oct 6, 2020
- Certification date
- Oct 6, 2020
- Last updated
- Oct 6, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | – | Yes |
Practice location
4849 Lone Tree WaySuite C
Antioch, CA 94531-8644
Phone 303-989-8169
Mailing address
4849 Lone Tree WaySuite C
Antioch, CA 94531-8644
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