Individual provider · Type 1 NPI

Wyatt Russom

Behavior Technician · Poplar Bluff, MO

NPI number 1609562883 Active

Practice location

2995 Warrior Ln
Poplar Bluff, MO 63901-8600

Call (573) 712-2902 Map

Specialties and licenses

TaxonomyCodeLicense
Behavior Technician Primary 106S00000XNone listed

Behavior Technician: The behavior technician is a paraprofessional who practices under the close, ongoing supervision of a behavior analyst or assistant behavior analyst certified by the Behavior Analyst Certification Board and/or credentialed by a state (such as through licensure). The behavior technician is primarily responsible for the implementation of components of behavior-analytic treatment plans developed by the supervisor. That…

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About NPI 1609562883

Wyatt Russom's National Provider Identifier is 1609562883, issued on Apr 12, 2023. The primary taxonomy on file is Behavior Technician (106S00000X), and the practice location is in Poplar Bluff, MO. The record was last updated on Apr 12, 2023.