Adrienne Nicole Black
Behavior Technician
519 Woodland Dr Woodland Dr
Rockford
, Illinois 61108
Adrienne Nicole Black
Behavior Technician
519 Woodland Dr Woodland Dr
Rockford
, Illinois 61108
(779) 423-7812
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About
Features
Specialties
- Behavior Technician
Languages spoken
- English
Location
First Address
- Adrienne Nicole Black
- 519 Woodland Dr Woodland Dr
- Rockford, IL
- Zip : 61108
- Phone : (779) 423-7812
Second Address
- Adrienne Nicole Black
- 519 Woodland Dr Woodland Dr
- Rockford, IL
- Zip : 61108
- Phone : (779) 423-7812
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 106S00000X | Behavior Technician | RBT-17-45544 | IL |
National Provider Identifier
| NPI | 1003306465 |
|---|---|
| Provider Name | Adrienne Nicole Black |
| First Address | Rockford, IL 61108 |
| Second Address | Rockford, IL 61108 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 11/05/2018 |
| Last Update Date | 11/05/2018 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.