Makenna Bogen

Individual provider Active NPI Behavior Technician · Great Falls, MT

NPI 1104581172 · NPPES record last updated Aug 28, 2023

Key facts

NPI
1104581172
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
1601 2ND Ave N
Great Falls, MT 59401-3259
Phone
(062) 402-0454
NPI assigned
Nov 4, 2021
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)CodeLicenseStatePrimary
Behavior Technician 106S00000X Yes

Addresses

Primary practice location

1601 2ND Ave N
Great Falls, MT 59401-3259

Mailing address

1611 Highland Dr
Placerville, CA 95667-3607

Other providers in Great Falls, MT

All providers in Great Falls, MT · Behavior Technician in Montana

Sources for this page

Verify at the official NPI Registry.