Healthcare Provider Details

I. General information

NPI: 1023971736
Provider Name (Legal Business Name): TATIANA WEST RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/09/2025
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1299 FARNAM ST STE 300
OMAHA NE
68102-1857
US

IV. Provider business mailing address

2390 WEDGEWOOD DR UNIT 6250
AKRON OH
44312-2479
US

V. Phone/Fax

Practice location:
  • Phone: 317-732-8380
  • Fax: 855-892-0299
Mailing address:
  • Phone: 317-732-8380
  • Fax: 855-892-0299

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-25-495441
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: