Individual
KILEY JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A., BCBA
Contact information
Practice address
1555 SE DELAWARE AVE STE O, ANKENY, IA 50021-4011
(515) 261-2402
Mailing address
1555 SE DELAWARE AVE STE O, ANKENY, IA 50021-4011
(515) 261-2402
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-21-48268
IA
106S00000X
Behavior Technician
RBT-18-49382
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
822272447
PRIVATE INSURANCE AND PRIVATE PAY
IA
Enumeration date
02/09/2018
Last updated
03/11/2021
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