MEDICARE: ITCELL INFANTE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1417803719
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ITCELL INFANTE

Provider Business Mailing Address
First Line	:	3415 BATAAN MEMORIAL W
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88012-5012
Country	:	US
Telephone Number	:	505-392-3482
Fax Number	:

Provider Business Practice Location Address
First Line	:	846 GARROW RD
Second Line	:
City	:	NEWPORT NEWS
State	:	VA
Zip	:	23608-3364
Country	:	US
Telephone Number	:	757-696-4645
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/09/2026
Last Update Date	:	03/09/2026

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Directions to “ ITCELL INFANTE ” Practice Location

Language	Start Address	Practice Location

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