Jessica Amezquita

Individual provider Active NPI Behavior Technician · Dearborn, MI

NPI 1982190450 · NPPES record last updated Jul 7, 2018

Key facts

NPI
1982190450
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
6275 Schaefer Rd Ste 105
Dearborn, MI 48126-2210
Phone
(313) 652-6701
NPI assigned
Jul 7, 2018
Sex
Female
Sole proprietor
Yes

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
Asd Latinos Unlimited LLC Single Specialty Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician
Group: 193400000X SINGLE SPECIALTY GROUP
106S00000X Yes

Addresses

Primary practice location

6275 Schaefer Rd Ste 105
Dearborn, MI 48126-2210

Mailing address

6275 Schaefer Rd Ste 105
Dearborn, MI 48126-2210
Phone (313) 652-6701

Other providers in Dearborn, MI

All providers in Dearborn, MI · Behavior Technician in Michigan

Sources for this page

Verify at the official NPI Registry.