Individual
EMMALEIGH KATELYNN AVIANA DIEGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
1860 NW 118TH ST STE 100, CLIVE, IA 50325-8278
(888) 228-8476
Mailing address
1860 NW 118TH ST STE 100, CLIVE, IA 50325-8278
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
BACB1266241
IA
Other
Enumeration date
02/07/2025
Last updated
02/07/2025
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