Individual
BILLIE-NICOLE BOEHM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2632 FOOTHILL BLVD STE 205, ROCK SPRINGS, WY 82901-4758
(307) 751-4348
Mailing address
2632 FOOTHILL BLVD STE 205, ROCK SPRINGS, WY 82901-4758
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-20-133638
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RBT-20-133638
BACB
WY
Enumeration date
09/03/2020
Last updated
09/03/2020
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