Melissa Louise Keezer

Individual provider Active NPI Behavior Technician · Ogema, MN

NPI 1992279715 · NPPES record last updated Jan 15, 2019

Key facts

NPI
1992279715
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
301 Feather St
Ogema, MN 56569-6902
Phone
(218) 983-3011
Fax
(218) 983-3002
NPI assigned
Jan 15, 2019
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
White Earth Band of Ojibwe - Indian Child Welfare Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Yes

Addresses

Primary practice location

301 Feather St
Ogema, MN 56569-6902

Mailing address

301 Feather St
Ogema, MN 56569-6902
Phone (218) 983-3011

Other providers in Ogema, MN

All providers in Ogema, MN · Behavior Technician in Minnesota

Sources for this page

Verify at the official NPI Registry.