Antwanette Davis

Individual provider Active NPI Behavior Technician · Coffeyville, KS

NPI 1689319600 · NPPES record last updated May 3, 2022

Key facts

NPI
1689319600
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
2404 W 8TH St
Coffeyville, KS 67337-2931
Phone
(913) 213-0676
NPI assigned
May 3, 2022
Sex
Female
Sole proprietor
No

Organizations & group practices 2

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
Beyond the Individual Current
since May 8, 2022
Accepting new patients
Dr Ostmeyer LLC Behavior Technician Current
since May 8, 2022
Accepting new patients

Locations

2404 W 8th St
Coffeyville, KS 67337
Phone (620) 330-9036

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Yes

Addresses

Primary practice location

2404 W 8TH St
Coffeyville, KS 67337-2931

Mailing address

PO Box 860063
Shawnee, KS 66286-0063
Phone (913) 213-0676

Other providers in Coffeyville, KS

All providers in Coffeyville, KS · Behavior Technician in Kansas

Sources for this page

Verify at the official NPI Registry.