Roxanna Lee Simmons
Individual provider Active NPI Behavior Technician · Oakley, ID
NPI 1700624137 · NPPES record last updated Jul 18, 2024
Key facts
- NPI
- 1700624137
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- Practice address
- 645 W 2000 S
Oakley, ID 83346-9770 - Phone
- (208) 219-9880
- NPI assigned
- Jul 18, 2024
- Sex
- Female
- Sole proprietor
- Yes
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
645 W 2000 S
Oakley, ID 83346-9770
Mailing address
645 W 2000 S
Oakley, ID 83346-9770
Phone (208) 219-9880
Other providers in Oakley, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 18, 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.