Dru Victoria Boatner
Individual provider Active NPI Behavior Technician · Altoona, IA
NPI 1003531930 · NPPES record last updated Oct 4, 2022
Key facts
- NPI
- 1003531930
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- License
- 22-204131 (IA)
- Practice address
- 950 28TH Ave SW Ste 2
Altoona, IA 50009-3940 - Phone
- (515) 644-4134
- NPI assigned
- Oct 4, 2022
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22-204131 | IA | MD | Behavior Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Midwest Autism and Therapy Center of Iowa, LLC | Current |
Accepting new patients |
Locations
950 28th Ave SW
Ste 2
Altoona, IA 50009
Phone (515) 446-2075
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | 22-204131 | IA | Yes |
Addresses
Primary practice location
950 28TH Ave SW Ste 2
Altoona, IA 50009-3940
Mailing address
950 28TH Ave SW Ste 2
Altoona, IA 50009-3940
Phone (563) 554-3225
Other providers in Altoona, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 4, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.