Kayla Brooke Fanum
Behavior Technician
690 Cleveland Ave S Ste 100
Saint Paul
, Minnesota 55116-1319
Kayla Brooke Fanum
Behavior Technician
690 Cleveland Ave S Ste 100
Saint Paul
, Minnesota 55116-1319
(651) 927-0404
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About
Features
Specialties
- Behavior Technician
Languages spoken
- English
Location
First Address
- Kayla Brooke Fanum
- 690 Cleveland Ave S Ste 100
- Saint Paul, MN
- Zip : 55116-1319
- Fax : (651) 927-0404
- Phone : (651) 493-8412
Second Address
- Kayla Brooke Fanum
- 690 Cleveland Ave S Ste 100
- Saint Paul, MN
- Zip : 55116-1319
- Fax : (651) 927-0404
- Phone : (651) 493-8412
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 106S00000X | Behavior Technician |
National Provider Identifier
| NPI | 1003403494 |
|---|---|
| Provider Name | Kayla Brooke Fanum |
| First Address | Saint Paul, MN 55116-1319 |
| Second Address | Saint Paul, MN 55116-1319 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 31/12/2020 |
| Last Update Date | 31/12/2020 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.