NPI 1043067481

Mason W Jorgensen

Practitioner Behavior Technician Rexburg, ID

Practice location

Address: 859 S Yellowstone Hwy STE 202, Rexburg, ID 83440-5294
Phone: (307) 257-5487
Mailing address: PO Box 20310 Unit #55984, Cheyenne, WY 82003-7007

Registered specialties

Behavior Technician Primary

Behavioral Health & Social Service Providers Taxonomy 106S00000X

Other Behavior Technician providers in Idaho →

Registry record

NPI: 1043067481
Entity type: Individual
Sex (as registered): Male
NPI issued: 3 May 2024
Record last updated: 3 May 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.