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General NPI Number Information
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NPI Number | 1689529208
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Entity Type | Individual
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Provider Name | JAIDA M VIKE
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Gender | Female
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Dates
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Enumeration Date | 02/27/2026
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Last Update Date | 02/27/2026
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Provider Practice Location Address
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Address Line | 1307 STATE 69
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City | NEW GLARUS
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State | WI
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Zip | 53574
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Country | US
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Telephone | 608-921-9976
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Fax |
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Provider Business Mailing Address
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Address Line | 605 S CROSBY AVE
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City | JANESVILLE
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State | WI
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Zip | 53548-4428
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | V200-4330-2960-04
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License Number State | WI
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