Bethany Bachmann, RBT

Individual provider Active NPI Behavior Technician · Channahon, IL

NPI 1194201863 · NPPES record last updated Jul 16, 2018

Key facts

NPI
1194201863
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
License
18-60255 (IL)
Practice address
26421 W Stonebriar Way
Channahon, IL 60410-8740
Phone
(815) 685-2831
NPI assigned
Jul 16, 2018
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
18-60255ILMDBehavior Technician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X 18-60255 IL Yes

Addresses

Primary practice location

26421 W Stonebriar Way
Channahon, IL 60410-8740

Mailing address

26421 W Stonebriar Way
Channahon, IL 60410-8740
Phone (815) 685-2831

Other providers in Channahon, IL

All providers in Channahon, IL · Behavior Technician in Illinois

Sources for this page

Verify at the official NPI Registry.