Individual
KYLE WORTMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BCBA
Contact information
Practice address
9123 PALOMAS AVE NE, ALBUQUERQUE, NM 87109-6632
(505) 933-5961
Mailing address
9123 PALOMAS AVE NE, ALBUQUERQUE, NM 87109-6632
(505) 933-5961
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
50926853
—
NM
Enumeration date
06/11/2015
Last updated
02/16/2026
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