Mia Marie Wyatt
Behavior Technician
611 N Brand Blvd
Glendale
, California 91203-1221
Mia Marie Wyatt
Behavior Technician
611 N Brand Blvd
Glendale
, California 91203-1221
(626) 214-6277
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About
Features
Specialties
- Behavior Technician
Languages spoken
- English
Location
First Address
- Mia Marie Wyatt
- 2092 Summit Ave
- Altadena, CA
- Zip : 91001-5720
- Phone : (626) 214-6277
Second Address
- Mia Marie Wyatt
- 611 N Brand Blvd
- Glendale, CA
- Zip : 91203-1221
- Phone : (747) 286-2600
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 106S00000X | Behavior Technician |
National Provider Identifier
| NPI | 1003402082 |
|---|---|
| Provider Name | Mia Marie Wyatt |
| First Address | Altadena, CA 91001-5720 |
| Second Address | Glendale, CA 91203-1221 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 14/12/2020 |
| Last Update Date | 14/12/2020 |
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.