Alexzia R Widermyre

NPI #1346836608 in Rockwall, Texas

Provider Information

NPI Number: 1346836608
Entity Type: Individual
Name: Alexzia R Widermyre
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Behavior Technician
Enumeration Date: Dec 21, 2020
Last Updated: Dec 21, 2020

Practice Location

Address: 911 N GOLIAD ST
City: Rockwall
State: Texas
ZIP Code: 75087-2230
Phone: (469) 458-9021

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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