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General NPI Number Information
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NPI Number | 1770436446
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Entity Type | Individual
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Provider Name | DANIEL DEJESUS
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Gender | Male
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Dates
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Enumeration Date | 02/20/2026
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Last Update Date | 02/20/2026
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Provider Practice Location Address
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Address Line | 1101 N PROGRESS AVE STE 1
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City | SILOAM SPRINGS
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State | AR
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Zip | 72761-4343
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Country | US
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Telephone | 479-228-7387
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Fax |
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Provider Business Mailing Address
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Address Line | 1101 N PROGRESS AVE STE 8524
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City | SILOAM SPRINGS
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State | AR
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Zip | 72761-4343
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Country | US
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Telephone | 347-803-4137
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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-25-504160
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License Number State | AR
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