NPI 1073477758

Destinie Carlson

Practitioner Behavior Technician Cedar Rapids, IA

Practice location

Address: 2811 Wiley Blvd SW, Cedar Rapids, IA 52404-3228
Phone: (574) 387-4313
Mailing address: 1827 E Ireland Rd, South Bend, IN 46614-2845

Registered specialties

Behavior Technician Primary

Behavioral Health & Social Service Providers Taxonomy 106S00000X Licence RBT-25-428549 (IA)

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Registry record

NPI: 1073477758
Entity type: Individual
Sex (as registered): Female
NPI issued: 16 Dec 2025
Record last updated: 16 Dec 2025

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.