Jessie Bue

Individual provider Active NPI Behavior Technician · Saint Robert, MO

NPI 1669068151 · NPPES record last updated Jun 12, 2021

Key facts

NPI
1669068151
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
496 Old Route 66
Saint Robert, MO 65584-3728
Phone
(573) 246-6164
NPI assigned
Dec 18, 2020
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
Homemaker 376J00000X
Behavior Technician 106S00000X Yes

Addresses

Primary practice location

496 Old Route 66
Saint Robert, MO 65584-3728

Mailing address

31 Ellis St
Fort Leonard Wood, MO 65473-1105
Phone (614) 361-3439

Other practice location 1

6441 Spinnaker Dr
Lewis Center, OH 43035-9369
Phone (614) 600-0973

Other identifiers

IdentifierTypeStateIssuer
0346280MedicaidOH

Other providers in Saint Robert, MO

All providers in Saint Robert, MO · Behavior Technician in Missouri

Sources for this page

Verify at the official NPI Registry.