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Individual

KILEY ELIZABETH DEWHURST

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
BCBA

Contact information

Practice address
1860 NW 118TH ST STE 100, CLIVE, IA 50325-8278
(515) 402-0810
Mailing address
1860 NW 118TH ST STE 100, CLIVE, IA 50325-8278
(515) 402-0810

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
098529
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1-19-37347
BACB
Enumeration date
12/19/2019
Last updated
12/19/2019
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