NPI 1427323328 · live from the CMS NPI Registry
Fabian Banuelos
Social Worker, Clinical in Kenai, AK. National Provider Identifier 1427323328, active.
NPI record
| NPI | 1427323328 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Social Worker, Clinical 1041C0700X |
| Practice location | 508 Upland St, Kenai, AK 99611 |
| Practice phone | 907-335-7500 |
| Mailing address | 15138 Carols Way Dr, Houston, TX 77070 |
| Enumerated | March 12, 2012 |
| Last updated | November 5, 2024 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Behavior Analyst | 103K00000X | — |
| Social Worker, Clinical primary | 1041C0700X | 16436 (PR) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.