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General NPI Number Information
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NPI Number | 1780593848
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Entity Type | Individual
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Provider Name | DEONDRE PATTERSON
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Gender | Male
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Dates
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Enumeration Date | 09/03/2026
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Last Update Date | 09/03/2026
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Provider Practice Location Address
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Address Line | 6511 JOHNSON DR
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City | MISSION
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State | KS
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Zip | 66202-2616
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Country | US
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Telephone | 573-200-6476
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Fax |
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Provider Business Mailing Address
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Address Line | 333 W 46TH TER
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City | KANSAS CITY
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State | MO
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Zip | 64112-1545
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Country | US
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Telephone | 314-374-0781
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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 |
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License Number State | MO
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