IndividualActive
Fanny Mateo
NPI 1396699740 · Behavior Technician · Troy, IL
Provider details
- NPI number
- 1396699740
- Entity type
- Individual
- Primary specialty
- Behavior TechnicianBehavioral Health & Social Service Providers
- Sex
- Female
- Sole proprietor
- No
- License
- 1214416 (IL)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Practice location
411 Edwardsville Rd
Troy, IL 62294-1339
Phone: (314) 275-0506
Approximate (ZIP-level) locationGet directions
Mailing address
848 N 89th St
East Saint Louis, IL 62203-2111
Registry dates
- Enumerated
- 2026-02-23
- Last updated
- 2026-02-23
- Certified
- 2026-02-23
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.