Jessica Kelley Westover
Individual provider Active NPI Behavior Technician · Shelley, ID
NPI 1285200543 · NPPES record last updated May 27, 2021
Key facts
- NPI
- 1285200543
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- Practice address
- 532 E 1500 N
Shelley, ID 83274-5032 - Phone
- (208) 604-2389
- NPI assigned
- May 27, 2021
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Yes |
Addresses
Primary practice location
532 E 1500 N
Shelley, ID 83274-5032
Mailing address
PO Box 7
Shelley, ID 83274-0007
Phone (208) 604-2389
Other providers in Shelley, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 27, 2021. 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.