MAXILEA ISOM (NPI# 1346776804) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346776804 |
| Entity Type | Individual |
| Full Name | MAXILEA ISOM |
| Practice Address |
2079 Eglin Ave Apt A Holloman, Afb NM 88330 |
| Mailing Address |
2079 Eglin Ave Apt A Holloman Afb NM 88330-7209 |
| Practice Telephone | 3474858386 |
| Mailing Telephone | 3474858386 |
| Enumeration Date | 2017-05-03 |
| Last Update Date | 2017-05-03 |
| 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 |
2079 EGLIN AVE APT A |
| City | HOLLOMAN, AFB |
| State | NM |
| Zip Code | 88330 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598312084 | Zachary James Smith | Pharmacist | 49th Medical Group 280 First Street, Holloman Afb, NM 88330 | 2019-08-20 |
| 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 |
| 1386849024 | Matthew Atwood | Social Worker | 200 First St., Bldg 17, Holloman Afb, NM 88330 | 2007-06-20 |
| 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 |
|---|---|---|---|---|
| 1891396057 | Heather Smith | Behavior Technician | 25a Cr 5060, Bloomfield, NM 87413 | 2020-11-04 |
| 1215538343 | Victoria Lopez | Behavior Technician | 1015 Pinatubo Pl Nw, Albuquerque, NM 87120-2974 | 2020-11-04 |
| 1467053967 | Candace Torres | Behavior Technician | 2572 Las Alturas Ct, Alamogordo, NM 88310-4339 | 2020-11-03 |
| 1598366080 | Maya Mascarenas | Behavior Technician | 516 Madeira Dr Se Apt 3, Albuquerque, NM 87108-2971 | 2020-11-03 |
| 1831790419 | Alisa Maria Salazar | Behavior Technician | 9610 Arvada Ave Ne, Albuquerque, NM 87112-2912 | 2020-11-02 |
| 1548861065 | Darren Anzures | Behavior Technician | 10004 Benavides Rd Sw, Albuquerque, NM 87121-8126 | 2020-11-02 |
| 1851992374 | Sara Olguin | Behavior Technician | 2910 Mountain View Dr, Carlsbad, NM 88220-3157 | 2020-11-02 |
| 1548869068 | Marian Kinsel | Behavior Technician | 5107 Loma Alto Dr, Farmington, NM 87402-8344 | 2020-10-26 |
| 1730788241 | Krysta Balzano | Behavior Technician | 1000 Paseo Del Gallo, Bernalillo, NM 87004-5558 | 2020-10-26 |
| 1376142935 | Amber Giles | Behavior Technician | 401 N Frontier St, Bloomfield, NM 87413-5529 | 2020-10-23 |
| Find all providers with the same taxonomy | ||||
| City | HOLLOMAN, AFB |
| Zip Code | 88330 |
Please comment or provide details below to improve the information on MAXILEA ISOM.
| 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.