MEDICARE: HILDA WAUJANI MOSER RBT 19-86268

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	19-86268	IL

General Provider Information

NPI Number	:	1629606777
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HILDA WAUJANI MOSER RBT 19-86268

Provider Business Mailing Address
First Line	:	122 108TH ST
Second Line	:
City	:	PLEASANT PRAIRIE
State	:	WI
Zip	:	53158-5105
Country	:	US
Telephone Number	:	224-480-6564
Fax Number	:

Provider Business Practice Location Address
First Line	:	1433 N WATER ST
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53202-2557
Country	:	US
Telephone Number	:	224-480-6564
Fax Number	:

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

Provider Enumeration Date	:	04/01/2020
Last Update Date	:	08/20/2025

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