Makayla Virginia Rose Bauer
Behavior Technician in Edwardsville, IL. Individual provider (NPI-1).
NPI number1699463562
StatusActive
Last updated in NPPESApr 27, 2023
Details
- NPI
- 1699463562
- Entity type
- Individual (NPI-1)
- Name
- Makayla Virginia Rose Bauer
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Apr 27, 2023
- Certification date
- Apr 27, 2023
- Last updated
- Apr 27, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | – | Yes |
Practice location
400 Saint Louis St Ste 1Edwardsville, IL 62025-1979
Phone 618-226-4397
Mailing address
2566 Parkview Dr Apt 3Granite City, IL 62040-8208
Phone 217-461-2531
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All 80 Behavior Technician providers in Edwardsville · All 899 providers in Edwardsville
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