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General NPI Number Information
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NPI Number | 1750297651
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Entity Type | Individual
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Provider Name | RODERICK ALAN FISHER III RBT
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Gender | Male
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Dates
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Enumeration Date | 08/20/2026
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Last Update Date | 08/20/2026
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Provider Practice Location Address
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Address Line | 800 E 101ST TER STE 350
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City | KANSAS CITY
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State | MO
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Zip | 64131-5310
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Country | US
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Telephone | 816-371-4180
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Fax |
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Provider Business Mailing Address
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Address Line | 7626 WATSON RD APT B302
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City | SAINT LOUIS
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State | MO
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Zip | 63119-5722
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Country | US
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Telephone | 573-233-9962
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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 | RBT-25-460875
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License Number State | MO
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