Kenyetta Hall
Individual provider Active NPI Behavior Technician · Glenwood, IL
NPI 1689499089 · NPPES record last updated Nov 20, 2024
Key facts
- NPI
- 1689499089
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- Practice address
- 900 W Sunset Dr Apt 603
Glenwood, IL 60425-1159 - Phone
- (708) 751-0954
- NPI assigned
- Nov 20, 2024
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Yes |
Addresses
Primary practice location
900 W Sunset Dr Apt 603
Glenwood, IL 60425-1159
Mailing address
900 W Sunset Dr Apt 603
Glenwood, IL 60425-1159
Other providers in Glenwood, IL
- Bridget Duggan
- Guameda Eady
- Genesis Cila Homes Inc
- Glenwood Healthcare & Rehab, Inc
- Glenwood Healthcare and Rehab
- Denetra L Hardy
- Arteasia Harris
- Health Providers
- Kayla Henry
- Vivian Diane Hudson-Davis
All providers in Glenwood, IL · Behavior Technician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 20, 2024. 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.