Kimberlee Haycock
Individual provider Active NPI Behavior Technician · Wendover, NV
NPI 1417488396 · NPPES record last updated Mar 23, 2017
Key facts
- NPI
- 1417488396
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- License
- RBT-16-13110 (NV)
- Practice address
- 1417 Cactus St
Wendover, NV 89883-3030 - Phone
- (775) 934-2745
- NPI assigned
- Mar 23, 2017
- 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-16-13110 | NV | MD | Behavior Technician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | RBT-16-13110 | NV | Yes |
Addresses
Primary practice location
1417 Cactus St
Wendover, NV 89883-3030
Mailing address
PO Box 3848
1417 Cactu St
Wendover, NV 89883-3848
Phone (775) 934-2745
Other providers in Wendover, NV
All providers in Wendover, NV · Behavior Technician in Nevada
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 23, 2017. 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.