Dylan Anthony Hackett-Provenzano
Dylan Anthony Hackett-Provenzano is a Behavior Technician in Stockton, California. Registered with an NPI since 2023.
- In the registry since
- 2023
Practice location Address checks out
1811 Grand Canal BlvdStockton, CA 95207-8155
Phone: (877) 418-2978
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Behavior Technician (primary) | Taxonomy 106S00000X |
|---|
Record details
| NPI number | 1063119741 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | No |
| NPI enumerated | February 13, 2023 |
| Last updated in NPPES | February 13, 2023 |
| Certification date | February 13, 2023 |
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