MISS DINA BREANNE MAXINE WOODWORTH (NPI# 1053955906) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053955906 |
| Entity Type | Individual |
| Full Name | MISS DINA BREANNE MAXINE WOODWORTH |
| Practice Address |
634 N Main St O Fallon IL 62269-3751 |
| Mailing Address |
2222 Rockwood Dr Belleville IL 62221-6839 |
| Practice Telephone | 6187260701 |
| Practice Fax Number | 2242101514 |
| Mailing Telephone | 8153834381 |
| Enumeration Date | 2019-11-04 |
| Last Update Date | 2019-11-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103K00000X | Behavioral Analyst | W363-1629-3972 | IL | Behavioral Health & Social Service Providers |
| Street Address |
634 N MAIN ST |
| City | O FALLON |
| State | IL |
| Zip Code | 62269-3751 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124044698 | Abc Pediatric Therapy, LLC | Occupational Therapist | 634 N Main St, Suite 3, O Fallon, IL 62269-3746 | 2006-07-15 |
| 1346899317 | Ashley Angela Watschinger | Behavior Technician | 634 N Main St, O Fallon, IL 62269-3751 | 2019-09-11 |
| 1548826316 | Elizabeth Conroy | Speech-Language Pathologist | 634 N Main St, O Fallon, IL 62269-3751 | 2019-05-16 |
| 1730742628 | Dominique Williams | Behavioral Analyst | 634 N Main St, O Fallon, IL 62269-3751 | 2019-04-17 |
| 1235691056 | Sheila Gerilyn Hipskind | Behavior Technician | 634 N Main St, O Fallon, IL 62269-3751 | 2019-04-01 |
| 1215498225 | Sarah Danielle Miller Salzman | Assistant Behavior Analyst | 634 N Main St, O Fallon, IL 62269-3751 | 2019-03-31 |
| 1053885749 | Marlon Van Ham | Behavioral Analyst | 634 N Main St, O Fallon, IL 62269-3751 | 2019-01-15 |
| 1245702869 | Mackenzie Archambo | Behavioral Analyst | 634 N Main St, O Fallon, IL 62269-3751 | 2018-12-20 |
| 1689165870 | Kendyl Ann Cuddihee | Behavior Technician | 634 N Main St, O Fallon, IL 62269-3746 | 2018-05-23 |
| 1225570138 | Melissa Lisk | Speech-Language Pathologist | 634 N Main St, Suite 3, O Fallon, IL 62269-3746 | 2016-11-09 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326648155 | Kayla Revermann | Pharmacist | 1350 W Us Highway 50, Pharmacy, O Fallon, IL 62269 | 2020-10-30 |
| 1942814272 | Ashley Monique Gibson | Behavior Technician | Eagle Center, Ste 10, Ofallon, IL 62269 | 2020-09-03 |
| 1013533819 | Michelle Denise Voudrie | Registered Nurse | 321 Regency Park, O'fallon, IL 62269 | 2020-06-18 |
| 1598398455 | Washington University Physicians In Illinois - Cancer Center Pharmacy | Pharmacy | 1418 Cross Street, Suite 180, Shiloh, IL 62269 | 2020-02-19 |
| 1962063800 | Gerald Paskert | Pharmacist | 122 W. State St., O'fallon, IL 62269 | 2019-06-21 |
| 1780144808 | Bonnie Jean Lampe | Physical Therapy Assistant | 316 Donna Dr, O'fallon, IL 62269 | 2019-03-24 |
| 1134633993 | Latisha Smith | Psychologist | 600 S. Smiley St., O'fallon, IL 62269 | 2017-11-30 |
| 1619407210 | Brenna M Thomas | Registered Nurse | 1310 Engle Ct, O'fallon, IL 62269 | 2017-06-15 |
| 1881135622 | Pc Associates, LLC | Family Medicine | 800 East Highway 50, O'fallon, IL 62269 | 2017-03-13 |
| 1700230539 | Jennifer Farrell | Family Medicine | 3 St. Elizabeth's Blvd, Ste. 4000, O'fallon, IL 62269 | 2016-04-18 |
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| Taxonomy Code | 103K00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Behavioral Analyst |
| A behavior analyst is qualified by at least a master’s degree and Behavior Analyst Certification Board certification and/or a state-issued credential (such as a license) to practice behavior analysis independently. Behavior analysts provide the required supervision to assistant behavior analysts and behavior technicians. A behavior analyst delivers services consistent with the dimensions of applied behavior analysis. Common services may include, but are not limited to, conducting behavioral assessments, analyzing data, writing and revising behavior-analytic treatment plans, training others to implement components of treatment plans, and overseeing implementation of treatment plans. |
| Notes: Source: Association of Professional Behavior Analysts, www.apbahome.net and Behavior Analyst Certification Board (http://www.bacb.com) [7/1/2008: new, 1/1/2016: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114587284 | Makayla Baker | Behavioral Analyst | 1001 Still Water Dr, O Fallon, IL 62269-3482 | 2019-06-19 |
| 1477923365 | Kathleen Elizabeth Hodskins | Behavioral Analyst | 6 Eagle Ctr, O Fallon, IL 62269-1945 | 2015-10-05 |
| 1225479157 | Keely Deanna Lawler Sabaini | Behavioral Analyst | 418 E Adams St, O Fallon, IL 62269-1423 | 2013-07-08 |
| 1366059859 | Becky Furry | Behavioral Analyst | 6 Eagle Ctr Ste 1, O Fallon, IL 62269-1945 | 2020-09-28 |
| 1871100768 | Queen Marisha Liburd | Behavioral Analyst | 6 Eagle Ctr Ste 1, O Fallon, IL 62269-1945 | 2020-09-25 |
| 1033728167 | Alexandra Thompson | Behavioral Analyst | 145 Springfield Ct, O Fallon, IL 62269-2495 | 2020-07-24 |
| 1770108912 | Paige Alexandra Frick | Behavioral Analyst | 6 Eagle Ctr Ste 1, O Fallon, IL 62269-1945 | 2020-06-13 |
| 1578185237 | Porscha Williams | Behavioral Analyst | 6 Eagle Ctr Ste 1, O Fallon, IL 62269-1945 | 2020-05-15 |
| 1427670306 | Amanda Kay Boeckman | Behavioral Analyst | 6 Eagle Ctr Ste 1, O Fallon, IL 62269-1945 | 2020-05-13 |
| 1659918977 | Daniel Mikel Childress | Behavioral Analyst | 145 Springfield Ct, O Fallon, IL 62269-2495 | 2019-12-05 |
| Find all providers in O FALLON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.