Jordey Skylar Brown-Smith

Individual provider Active NPI Behavior Technician · Fargo, ND

NPI 1407465396 · NPPES record last updated Jul 27, 2020

Key facts

NPI
1407465396
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
2800 Main Ave
Fargo, ND 58103-6811
Phone
(310) 490-1629
NPI assigned
Jul 27, 2020
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

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Yes

Addresses

Primary practice location

2800 Main Ave
Fargo, ND 58103-6811

Mailing address

2800 Main Ave
Fargo, ND 58103-6811
Phone (310) 490-1629

Other providers in Fargo, ND

All providers in Fargo, ND · Behavior Technician in North Dakota

Sources for this page

Verify at the official NPI Registry.