Deseray Nichole Suprise
NPI #1144873142 in Holloman Afb, New Mexico
Provider Information
- NPI Number
- 1144873142
- Entity Type
- Individual
- Name
- Deseray Nichole Suprise
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Behavior Technician
- Enumeration Date
- Jul 18, 2019
- Last Updated
- Jul 18, 2019
Practice Location
- Address
- 2516 CATRON LOOP APT B
- City
- Holloman Afb
- State
- New Mexico
- ZIP Code
- 88330-7415
- Phone
- (956) 502-7475
Specialties & Taxonomy Codes
| Specialty |
|---|
| Behavior Technician |
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