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NPI Code Detail

MEDICARE: DESTYNEE FOSTER

MEDICARE: DESTYNEE FOSTER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician
2106S00000XBehavior TechnicianNV

General Provider Information

NPI Number : 1447021548
Entity Type Code : Individual
Provider Name (Legal Business Name) : DESTYNEE FOSTER
Provider Business Mailing Address
First Line : 3850 W ANN RD
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89031-4406
Country : US
Telephone Number : 702-323-6555
Fax Number :
Provider Business Practice Location Address
First Line : 3850 W ANN RD
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89031-4406
Country : US
Telephone Number : 702-323-6555
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/09/2024
Last Update Date : 01/09/2024

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Directions to “ DESTYNEE FOSTER ” Practice Location

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