Individual
LARRIANE JIECEL TAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1408 8TH ST, ALAMOGORDO, NM 88310-5115
(866) 273-2451
Mailing address
1408 8TH ST, ALAMOGORDO, NM 88310-5115
(866) 273-2451
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
106S00000X
Behavior Technician
Primary
RBT-19-83323
NV
Other
Enumeration date
04/09/2019
Last updated
07/17/2025
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