Maguedalena Manoucheka Supreme
Behavior Technician in Hartford, CT. Individual provider (NPI-1).
NPI number1477366995
StatusActive
Last updated in NPPESJan 29, 2025
Details
- NPI
- 1477366995
- Entity type
- Individual (NPI-1)
- Name
- Maguedalena Manoucheka Supreme
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jan 29, 2025
- Certification date
- Jan 29, 2025
- Last updated
- Jan 29, 2025
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | CT | Yes |
Practice location
250 Main St Apt 812Hartford, CT 06106-1875
Phone 305-399-9176
Mailing address
250 Main St Apt 812Hartford, CT 06106-1875
Phone 305-399-9176
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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