Vanessa Bahena, RBT

Individual provider Active NPI Behavior Technician · Waukegan, IL

NPI 1245720481 · NPPES record last updated May 14, 2018

Key facts

NPI
1245720481
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
License
18-51098
Practice address
828 W Pacific Ave
Waukegan, IL 60085-1830
Phone
(224) 944-9175
NPI assigned
May 14, 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

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X 18-51098 Yes

Addresses

Primary practice location

828 W Pacific Ave
Waukegan, IL 60085-1830

Mailing address

828 W Pacific Ave
Waukegan, IL 60085-1830
Phone (224) 944-9175

Other providers in Waukegan, IL

All providers in Waukegan, IL · Behavior Technician in Illinois

Sources for this page

Verify at the official NPI Registry.