Provider Demographics
NPI:1477048072
Name:GERLAND, NICOLE RENE (RBT)
Entity Type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:RENE
Last Name:GERLAND
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 OPIE LN
Mailing Address - Street 2:
Mailing Address - City:CIBOLO
Mailing Address - State:TX
Mailing Address - Zip Code:78108-4121
Mailing Address - Country:US
Mailing Address - Phone:210-372-5881
Mailing Address - Fax:
Practice Address - Street 1:411 OPIE LN
Practice Address - Street 2:
Practice Address - City:CIBOLO
Practice Address - State:TX
Practice Address - Zip Code:78108-4121
Practice Address - Country:US
Practice Address - Phone:210-372-5881
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-26
Last Update Date:2018-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty