Keili Renee Vidales
Individual provider Active NPI Behavior Technician · Mentmore, NM
NPI 1497607105 · NPPES record last updated Feb 13, 2026
Key facts
- NPI
- 1497607105
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- Practice address
- PO Box 596
Mentmore, NM 87319-0596 - Phone
- (505) 870-0734
- NPI assigned
- Feb 13, 2026
- 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
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | NM | Yes |
Addresses
Primary practice location
PO Box 596
Mentmore, NM 87319-0596
Mailing address
PO Box 596
Mentmore, NM 87319-0596
Phone (505) 870-0734
Other providers in Mentmore, NM
All providers in Mentmore, NM · Behavior Technician in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 13, 2026. 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.