Most Relevant Information
Provider Data
| NPI Number: | 1003430182 |
| Provider Name: | VIVIAN IBARRA RBT |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: | RBT-20-120193 |
Most Important Dates
| Enumeration Date: | 06/03/2020 |
| Last Updated: | 06/03/2020 |
Provider Practice Location
201 REGENCY PKWY
MANSFIELD
TX
760635638
Practice Location Phone/Fax
| Phone: | 8177524945 |
| Fax: |
Provider Mailing Location
201 REGENCY PKWY
MANSFIELD
TX
760635638
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |