Individual
MRS. KAITLIN WOSTENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
1114 E 29TH ST, DAVENPORT, IA 52803-1902
(307) 421-3618
Mailing address
1114 E 29TH ST, DAVENPORT, IA 52803-1902
(307) 421-3618
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-20-41400
—
106S00000X
Behavior Technician
—
—
Other
Enumeration date
01/23/2018
Last updated
06/06/2023
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