Provider Demographics
NPI:1679275044
Name:UMPIERRES, ROBERTA (RBT)
Entity Type:Individual
Prefix:MRS
First Name:ROBERTA
Middle Name:
Last Name:UMPIERRES
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 1:10372 FORT ELLIOTT TRAIL
Mailing Address - Street 2:HOME
Mailing Address - City:CROWLEY
Mailing Address - State:TX
Mailing Address - Zip Code:76036
Mailing Address - Country:US
Mailing Address - Phone:817-983-4995
Mailing Address - Fax:
Practice Address - Street 1:10372 FORT ELLIOTT TRAIL
Practice Address - Street 2:HOME
Practice Address - City:CROWLEY
Practice Address - State:TX
Practice Address - Zip Code:76036-7603
Practice Address - Country:US
Practice Address - Phone:817-983-4995
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-20
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXRBT-20-135790106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician