Individual
RAVENNE BEATRICE GO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
401 W 2ND ST, RENO, NV 89503-5345
(775) 391-0749
Mailing address
1664 N VIRGINIA ST # MS 296, RENO, NV 89557-0001
(775) 682-8686
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-19-75286
NV
Other
Enumeration date
01/09/2019
Last updated
01/31/2019
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