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Individual

HEATHER LEE SUTTERFIELD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DSIII, BCBA

Contact information

Practice address
152 NEW MEXICO 88, PORTALES, NM 88130-9293
(660) 233-6863
Mailing address
152 NEW MEXICO 88, PORTALES, NM 88130-9293

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-20-42167
NM
106S00000X
Behavior Technician

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
106S00000X
BEHAVIOR HEALTH
Enumeration date
08/07/2018
Last updated
05/26/2020
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