NPI 1528638921 · live from the CMS NPI Registry
Samantha Green
Behavior Technician in Eagle River, AK. National Provider Identifier 1528638921, active.
NPI record
| NPI | 1528638921 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Behavior Technician 106S00000X |
| Practice location | 16941 N Eagle River Loop Rd, Eagle River, AK 99577 |
| Practice phone | 907-726-5330 |
| Enumerated | June 28, 2021 |
| Last updated | June 9, 2022 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Behavior Analyst | 103K00000X | — (AK) |
| Peer Specialist | 175T00000X | — (AK) |
| Behavior Technician primary | 106S00000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.