Amy J Wondergem

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

401 10TH Ave
Menominee, MI 49858-3009

Phone

(906) 863-7841

NPI assigned

Sep 27, 2023

Last updated

Sep 27, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1695772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695772800000",
    "number": "1174302327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 10TH AVE",
            "city": "MENOMINEE",
            "state": "MI",
            "postal_code": "498583009",
            "telephone_number": "906-863-7841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 10TH AVE",
            "city": "MENOMINEE",
            "state": "MI",
            "postal_code": "498583009",
            "telephone_number": "906-863-7841"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1117 14th Ave",
            "address_purpose": "LOCATION",
            "city": "Menominee",
            "state": "MI",
            "postal_code": "498582962",
            "country_code": "US",
            "telephone_number": "715-927-1660",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WONDERGEM",
        "first_name": "AMY",
        "middle_name": "J",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-27",
        "last_updated": "2023-09-27",
        "certification_date": "2023-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Behavior Technician in Menominee, MI
• Providers in Menominee, MI by specialty
• Behavior Technician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.