Individual
MR. TEVIS DORRELL ADULARESCENCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PEER SUPPORT
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
106S00000X
Behavior Technician
—
—
171M00000X
Case Manager/Care Coordinator
—
—
172V00000X
Community Health Worker
—
—
175T00000X
Peer Specialist
Primary
—
—
372500000X
Chore Provider
—
—
372600000X
Adult Companion
—
—
374700000X
Technician
—
—
Other
Enumeration date
02/16/2023
Last updated
08/18/2024
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