Kaleb Mogard

Individual provider Active NPI Behavior Analyst · Bismarck, ND

NPI 1649896309 · NPPES record last updated Mar 21, 2023

Key facts

NPI
1649896309
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Analyst 103K00000X
License
1-23-64704 (ND)
Practice address
4503 Coleman St Ste 203
Bismarck, ND 58503-2017
Phone
(218) 287-4338
NPI assigned
Jun 18, 2020
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
Specialist 174400000X
Behavior Analyst 103K00000X 1-23-64704 ND Yes

Addresses

Primary practice location

4503 Coleman St Ste 203
Bismarck, ND 58503-2017

Mailing address

1547 30TH Ave S
Moorhead, MN 56560-5149

Other practice location 1

1126 Westrac Dr S
Fargo, ND 58103-2473
Phone (218) 287-4338

Other providers in Bismarck, ND

All providers in Bismarck, ND · Behavior Analyst in North Dakota

Sources for this page

Verify at the official NPI Registry.