Angel S Sutcliffe

Individual provider Active NPI Behavior Technician · Kingman, IN

NPI 1750191508 · NPPES record last updated Jan 13, 2025

Key facts

NPI
1750191508
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
2700 E Limepit Rd
Kingman, IN 47952-8030
Phone
(765) 749-2763
NPI assigned
Jan 13, 2025
Sex
Female
Sole proprietor
No

Organizations & group practices 1

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
Jax Services, LLC Current
since Jan 19, 2025
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Yes

Addresses

Primary practice location

2700 E Limepit Rd
Kingman, IN 47952-8030

Mailing address

2700 E Limepit Rd
Kingman, IN 47952-8030
Phone (765) 749-2763

Other providers in Kingman, IN

All providers in Kingman, IN · Behavior Technician in Indiana

Sources for this page

Verify at the official NPI Registry.