Provider Demographics
NPI:1235948498
Name:STERMER, KYLIE ANGELIQUE (RBT)
Entity type:Individual
Prefix:MISS
First Name:KYLIE
Middle Name:ANGELIQUE
Last Name:STERMER
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 1:200 SPRINGTOWN WAY APT 203A
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:TX
Mailing Address - Zip Code:78666-7143
Mailing Address - Country:US
Mailing Address - Phone:940-855-7511
Mailing Address - Fax:
Practice Address - Street 1:200 SPRINGTOWN WAY
Practice Address - Street 2:203A
Practice Address - City:SAN MARCOS
Practice Address - State:TX
Practice Address - Zip Code:78666
Practice Address - Country:US
Practice Address - Phone:940-642-1615
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-02
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBACB1223479106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician