Distant-Goulbourne, Tanya

Distant-Goulbourne, Tanya is an individual health care provider with primary practice located at 820 E Williams St , Barstow CA 92311-3048. She recently has only one registered license in Behavioral Health & Social Service Providers / Behavior Technician, which is considered as her primary health care specialty. Distant-Goulbourne, Tanya can be contacted via phone (855) 581-0100.

Contact Information

Primary practice address
820 E Williams St Barstow CA 92311-3048
Phone: (855) 581-0100
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Behavior Technician 106S00000X

Profile Details

NPI number 1396353942
LBN Legal business name Distant-Goulbourne, Tanya
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 20th, 2020
Last updated Jul 20th, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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