Montanna Rae Requa

NPI #1558905679 in Juneau, Alaska

Provider Information

NPI Number: 1558905679
Entity Type: Individual
Name: Montanna Rae Requa
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: Oct 31, 2019
Last Updated: Oct 31, 2019

Practice Location

Address: 4511 CHELSEA CT
City: Juneau
State: Alaska
ZIP Code: 99801-7309
Phone: (907) 957-8680

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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