Jennifer Bushmaker

Individual provider Active NPI Behavior Technician · Two Harbors, MN

NPI 1578106977 · NPPES record last updated Oct 18, 2019

Key facts

NPI
1578106977
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
115 7TH St
Two Harbors, MN 55616-1528
Phone
(218) 834-6005
Fax
(218) 724-4041
NPI assigned
Oct 18, 2019
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Accend Services Incorporated Current
since Feb 15, 2020
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Yes

Addresses

Primary practice location

115 7TH St
Two Harbors, MN 55616-1528

Mailing address

101 W 2ND St
Duluth, MN 55802-2086
Phone (218) 724-3122

Other names

  • Jennifer Gezella Former name

Other providers in Two Harbors, MN

All providers in Two Harbors, MN · Behavior Technician in Minnesota

Sources for this page

Verify at the official NPI Registry.