Misty D Belanger

Individual provider Active NPI Behavior Technician · Clovis, NM

NPI 1487941233 · NPPES record last updated Oct 17, 2023

Key facts

NPI
1487941233
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
2000 W 21St St
Clovis, NM 88101-4087
Phone
(575) 288-1881
Fax
(575) 288-1889
NPI assigned
Jun 30, 2011
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
Case Manager/Care Coordinator 171M00000X
Behavior Technician 106S00000X Yes

Addresses

Primary practice location

2000 W 21St St
Clovis, NM 88101-4087

Mailing address

1350 Hillrise Cir
Las Cruces, NM 88011-4759
Phone (575) 288-1881

Other practice location 1

1100 W 21st Street
Clovis, NM 88101
Phone (575) 769-2345 ext. 130

Other providers in Clovis, NM

All providers in Clovis, NM · Behavior Technician in New Mexico

Sources for this page

Verify at the official NPI Registry.