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General NPI Number Information
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NPI Number | 1760387070
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Entity Type | Individual
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Provider Name | CECEDRA MASTERS
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Gender | Female
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Dates
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Enumeration Date | 10/08/2026
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Last Update Date | 10/08/2026
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Provider Practice Location Address
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Address Line | 801 E DOUGLAS AVE FL 2
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City | WICHITA
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State | KS
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Zip | 67202-3548
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Country | US
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Telephone | 620-712-8820
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Fax |
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Provider Business Mailing Address
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Address Line | 801 E DOUGLAS AVE FL 2
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City | WICHITA
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State | KS
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Zip | 67202-3548
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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 | RBT-26-2831174
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License Number State | KS
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