Provider Demographics
NPI:1447717723
Name:NDURU, EUGENE (BCBA)
Entity type:Individual
Prefix:
First Name:EUGENE
Middle Name:
Last Name:NDURU
Suffix:
Gender:M
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2804 E 26TH ST STE 1
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57103-4019
Mailing Address - Country:US
Mailing Address - Phone:605-271-2690
Mailing Address - Fax:605-271-3956
Practice Address - Street 1:745 10TH ST STE C
Practice Address - Street 2:
Practice Address - City:ROCK VALLEY
Practice Address - State:IA
Practice Address - Zip Code:51247-1511
Practice Address - Country:US
Practice Address - Phone:605-271-2690
Practice Address - Fax:605-271-3956
Is Sole Proprietor?:No
Enumeration Date:2019-02-22
Last Update Date:2019-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
SD1-19-38801103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician