Provider Demographics
NPI:1073271458
Name:TREIBER, DILLON (BEHAVIOR TECHNICIAN)
Entity Type:Individual
Prefix:
First Name:DILLON
Middle Name:
Last Name:TREIBER
Suffix:
Gender:F
Credentials:BEHAVIOR TECHNICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1511 S SHANNON RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85713-1052
Mailing Address - Country:US
Mailing Address - Phone:520-639-2351
Mailing Address - Fax:
Practice Address - Street 1:4501 N CAMINO DEL OBISPO
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85718-6605
Practice Address - Country:US
Practice Address - Phone:855-462-3672
Practice Address - Fax:855-462-3672
Is Sole Proprietor?:No
Enumeration Date:2021-12-02
Last Update Date:2021-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician