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Individual
DERRICK FOSTER
Active
Individual
DERRICK FOSTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RBT
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-19-109493
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RBT-19-109493
NA
TX
Enumeration date
04/20/2020
Last updated
04/20/2020
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