Provider Demographics
NPI:1184466856
Name:REISER, JANE CURTIS (MED, JD, RBT)
Entity type:Individual
Prefix:
First Name:JANE
Middle Name:CURTIS
Last Name:REISER
Suffix:
Gender:F
Credentials:MED, JD, RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2549 N STOKESBERRY PL
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83646-1144
Mailing Address - Country:US
Mailing Address - Phone:478-449-5275
Mailing Address - Fax:208-268-6268
Practice Address - Street 1:2549 N STOKESBERRY PL
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83646-1144
Practice Address - Country:US
Practice Address - Phone:478-449-5275
Practice Address - Fax:208-268-6268
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-12
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDRBT-24-351304106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician