DESERAY NICHOLE SUPRISE (NPI# 1144873142) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144873142 |
| Entity Type | Individual |
| Full Name | DESERAY NICHOLE SUPRISE |
| Practice Address |
2516 Catron Loop Apt B Holloman Afb NM 88330-7415 |
| Practice Telephone | 9565027475 |
| Mailing Telephone | 9565027475 |
| Enumeration Date | 2019-07-18 |
| Last Update Date | 2019-07-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106S00000X | Behavior Technician | Behavioral Health & Social Service Providers |
| Street Address |
2516 CATRON LOOP APT B |
| City | HOLLOMAN AFB |
| State | NM |
| Zip Code | 88330-7415 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598312084 | Zachary James Smith | Pharmacist | 49th Medical Group 280 First Street, Holloman Afb, NM 88330 | 2019-08-20 |
| 1346776804 | Maxilea Isom | Behavior Technician | 2079 Eglin Ave Apt A, Holloman, Afb, NM 88330 | 2017-05-03 |
| 1932558665 | Courtney Davis | Day Training/Habilitation Specialist | 2228 La Luz Pkwy Unit A, Holloman Afb, NM 88330 | 2016-06-03 |
| 1568849255 | Ryan Abner | Registered Nurse | 49th Medical Building 17, Holloman Afb, NM 88330 | 2015-05-01 |
| 1710384292 | United States Air Force | Military Hospital | 49th Medical Bldg 17, Holloman Afb, NM 88330 | 2014-11-26 |
| 1174934764 | Jason Gordon | Social Worker | 1st Street Holloman Afb, Holloman Afb, NM 88330 | 2014-05-16 |
| 1649512807 | Philip Walker | Internal Medicine | 280 1st St, Holloman Afb, Alamogordo, NM 88330 | 2013-03-25 |
| 1275891889 | Sunland Optical Co., Inc. | Eyewear Supplier (Equipment, not the service) | 551 4th Street, Bldg. 227, Holloman Afb, NM 88330 | 2012-05-02 |
| 1568606317 | Kimberly Dawn Jensen | Internal Medicine | 280 1st St Bldg 15, 49 Mdg Holloman Afb, Holloman Afb, NM 88330 | 2009-04-23 |
| 1700042306 | Bettina Watkins | Family Medicine | 280 First St, Bldg 23, Holloman Afb, NM 88330 | 2008-08-03 |
| Find all providers in zip 88330 | ||||
| Taxonomy Code | 106S00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Behavior Technician |
| The behavior technician is a paraprofessional who practices under the close, ongoing supervision of a behavior analyst or assistant behavior analyst certified by the Behavior Analyst Certification Board and/or credentialed by a state (such as through licensure). The behavior technician is primarily responsible for the implementation of components of behavior-analytic treatment plans developed by the supervisor. That may include collecting data on treatment targets and conducting certain types of behavioral assessments (e.g., stimulus preference assessments). The behavior technician does not design treatment or assessment plans or procedures but provides services as assigned by the supervisor responsible for his or her work. |
| Notes: Association of Professional Behavior Analysts, www.apbahome.net and Behavior Analyst Certification Board (http://www.bacb.com) [7/1/2016: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538705785 | Nicole Ann Percy | Behavior Technician | 2821 Quay Loop Apt B, Holloman Afb, NM 88330-8194 | 2019-11-22 |
| 1134762727 | Harmony Lynne Hartung | Behavior Technician | 2774 Sandoval Loop Apt A, Holloman Afb, NM 88330-7133 | 2019-10-25 |
| 1427691393 | Erica Xavier Aumand | Behavior Technician | 2347 Sierra Blanca Loop Apt B, Holloman Afb, NM 88330-8372 | 2019-10-23 |
| 1144879677 | Lacey Celina Robinson | Behavior Technician | 2437 Eddy Loop Apt A, Holloman Afb, NM 88330-8489 | 2019-09-06 |
| 1588221303 | Kayla Garrett | Behavior Technician | 2487 Taos Loop Apt A, Holloman Afb, NM 88330-8571 | 2019-05-28 |
| 1700449774 | Michelle Blumenthal | Behavior Technician | 1051 Connecticut Ave, Holloman Afb, NM 88330-8092 | 2019-04-16 |
| 1407318876 | Anastasiia Kviatkivska | Behavior Technician | 2086 Eglin Ave Apt B, Holloman Afb, NM 88330-7216 | 2019-04-03 |
| 1770044612 | Abigail Marie Kildow | Behavior Technician | 2074 Bell Ave Apt B, Holloman Afb, NM 88330-8325 | 2019-03-25 |
| 1942760442 | Lauren Danielle Olivares | Behavior Technician | 2105 Mescalero Loop Apt B, Holloman Afb, NM 88330-7653 | 2019-03-21 |
| 1942772124 | Jessica Ann O'banion | Behavior Technician | 2820b Quay Loop Unit B, Holloman Afb, NM 88330-8109 | 2018-12-27 |
| Find all providers in HOLLOMAN AFB | ||||
| City | HOLLOMAN AFB |
| Zip Code | 88330 |
Please comment or provide details below to improve the information on DESERAY NICHOLE SUPRISE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.