Jaqueline Galicia
Individual provider Active NPI Behavior Technician · Mishawaka, IN
NPI 1215733233 · NPPES record last updated Feb 20, 2025
Key facts
- NPI
- 1215733233
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- License
- RBT-24-390929 (IN)
- Practice address
- 3730 Edison Lakes Pkwy
Mishawaka, IN 46545-3424 - Phone
- (574) 387-4313
- NPI assigned
- Feb 20, 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-24-390929 | IN | MD | Behavior Technician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | RBT-24-390929 | IN | Yes |
Addresses
Primary practice location
3730 Edison Lakes Pkwy
Mishawaka, IN 46545-3424
Mailing address
215 Red Coach Dr
Mishawaka, IN 46545-8307
Phone (574) 387-4313
Other providers in Mishawaka, IN
- Noah Gaffney
- Gahc3 Mishawaka in Alf TRS Sub, LLC
- Magdalena Gakwandi
- Janet Ann Galanes
- Galen Inpatient Physicians PC
- Daniel Gallegos
- Courtney Claire Galloway
- Mikhail M Galperin
- Amanda Gamble
- Jocelyn Danielle Gaona
All providers in Mishawaka, IN · Behavior Technician in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 20, 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.