Daijah Eman Boatner

Key facts

NPI

1295463586

Entity type

Individual (NPI type 1)

Primary specialty

Behavior Technician 106S00000X

Practice address

773 Bandit TRL
Keller, TX 76248-0111

Phone

(817) 576-6396

NPI assigned

Aug 12, 2022

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

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 12, 2022.

{
    "created_epoch": "1660262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660262400000",
    "number": "1295463586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9233 SILVER DOLLAR DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761311923",
            "telephone_number": "316-670-4077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "773 BANDIT TRL",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "762480111",
            "telephone_number": "817-576-6396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOATNER",
        "first_name": "DAIJAH",
        "middle_name": "EMAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-12",
        "last_updated": "2022-08-12",
        "certification_date": "2022-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Keller, TX

• Danielle Jones Bludau
• Blue Bee Collective, PLLC
• Blue Sprig Pediatrics
• Jojo Marie Blue
• Charles Knox Boatner, DDS
• Claudine Gabriella Boeck, RPH
• Paula J. Boerman, M.S., CCC-SLP
• Kadie Elizabeth Bolton, MA., BCBA, LBA
• Sylvia C Bonniwell, CLC
• Stephanie Bowles

All providers in Keller, TX · Behavior Technician in Texas