Hailey Kristine Otte

Individual provider Active NPI Behavior Technician · Fargo, ND

NPI 1972364677 · NPPES record last updated May 17, 2024

Key facts

NPI
1972364677
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
License
RBT-24-322486
Practice address
4215 31St Ave S Ste a
Fargo, ND 58104-7743
Phone
(701) 478-0221
NPI assigned
Jan 19, 2024
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
Integrated Intervention Specialists, LLC Current
since Jan 21, 2024
Accepting new patients

Locations

4215 31st Ave S
Ste A
Fargo, ND 58104
Phone (701) 478-0221

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X
Behavior Technician 106S00000X RBT-24-322486 Yes

Addresses

Primary practice location

4215 31St Ave S Ste a
Fargo, ND 58104-7743

Mailing address

504 7TH St NE
Dilworth, MN 56529-1103
Phone (701) 552-0753

Other providers in Fargo, ND

All providers in Fargo, ND · Behavior Technician in North Dakota

Sources for this page

Verify at the official NPI Registry.