NPI 1073349734

Carlie Marie Johanningmeier

Practitioner Behavior Technician Davenport, IA

Practice location

Address: 4959 Utica Ridge Rd, Davenport, IA 52807-3063
Phone: (563) 362-9631

Registered specialties

Behavior Technician Primary

Behavioral Health & Social Service Providers Taxonomy 106S00000X Licence RBT-24-375780 (IA)

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Registry record

NPI: 1073349734
Entity type: Individual
Sex (as registered): Female
NPI issued: 10 Sep 2024
Record last updated: 10 Sep 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.