Wendlamita Fatim Aida Ouedraogo

Individual provider Active NPI Behavior Technician · Ralston, NE

NPI 1285489773 · NPPES record last updated Apr 18, 2024

Key facts

NPI
1285489773
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
6709 S 73Rd Street Cir Apt 5
Ralston, NE 68127-5316
Phone
(509) 900-8095
NPI assigned
Apr 18, 2024
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 NE Yes

Addresses

Primary practice location

6709 S 73Rd Street Cir Apt 5
Ralston, NE 68127-5316

Mailing address

6709 S 73Rd Street Cir Apt 5
Ralston, NE 68127-5316

Other providers in Ralston, NE

All providers in Ralston, NE · Behavior Technician in Nebraska

Sources for this page

Verify at the official NPI Registry.