Imani Willow Anderson
Individual provider Active NPI Behavior Technician · Brookfield, WI
NPI 1023989258 · NPPES record last updated Sep 12, 2025
Key facts
- NPI
- 1023989258
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- Practice address
- 200 N Patrick Blvd Ste 250
Brookfield, WI 53045-5883 - Phone
- (888) 754-0398
- NPI assigned
- Sep 12, 2025
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | WI | Yes |
Addresses
Primary practice location
200 N Patrick Blvd Ste 250
Brookfield, WI 53045-5883
Mailing address
3763 N 12TH St
Milwaukee, WI 53206-3004
Phone (262) 416-2140
Other providers in Brookfield, WI
- Caitlin Marie Anason
- Anastasia Care Home LLC
- Thomas Andersen
- Alexis Anderson
- Aviha Anderson
- Katrina L Anderson
- Kelli Jo Anderson
- Krystle Fawn Anderson
- Michelle L. Anderson
- Weston Garrett Andrews
All providers in Brookfield, WI · Behavior Technician in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 12, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.