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NPI Code Detail

MEDICARE: ANGELINA HOUTMAN

MEDICARE: ANGELINA HOUTMAN
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1790542603
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANGELINA HOUTMAN
Provider Business Mailing Address
First Line : 913 SHEIDLEY AVE STE 200
Second Line :
City : BONNER SPRINGS
State : KS
Zip : 66012-1825
Country : US
Telephone Number : 913-390-3775
Fax Number :
Provider Business Practice Location Address
First Line : 913 SHEIDLEY AVE STE 200
Second Line :
City : BONNER SPRINGS
State : KS
Zip : 66012-1825
Country : US
Telephone Number : 913-390-3775
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/06/2024
Last Update Date : 03/06/2024

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Directions to “ ANGELINA HOUTMAN ” Practice Location

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