Individual
DAISY MIRELES CHAVEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
209 W 20TH ST, GRAND ISLAND, NE 68801-2370
(308) 339-9176
Mailing address
209 W 20TH ST, GRAND ISLAND, NE 68801-2370
(308) 339-9176
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
BCBA799654
NE
Other
Enumeration date
06/14/2022
Last updated
06/14/2022
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