Casey Fodness, RBT

Individual provider Active NPI Behavior Technician · Sioux Falls, SD

NPI 1497230403 · NPPES record last updated Oct 15, 2019

Key facts

NPI
1497230403
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
1105 W Russell St
Sioux Falls, SD 57104-1322
Phone
(605) 271-2690
Fax
(605) 271-3956
NPI assigned
Sep 26, 2018
Sex
Male
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

1105 W Russell St
Sioux Falls, SD 57104-1322

Mailing address

2804 E 26TH St Ste 1
Sioux Falls, SD 57103-4019
Phone (605) 271-2690

Other practice location 1

1101 W Russell St
Sioux Falls, SD 57104-1322
Phone (605) 271-2690

Other providers in Sioux Falls, SD

All providers in Sioux Falls, SD · Behavior Technician in South Dakota

Sources for this page

Verify at the official NPI Registry.