Abigail Jo Bonner
Individual provider Active NPI Behavior Technician · Waterloo, IA
NPI 1073480992 · NPPES record last updated Oct 23, 2025
Key facts
- NPI
- 1073480992
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- Practice address
- 815 Tower Park Dr
Waterloo, IA 50701-9027 - Phone
- (319) 217-9256
- NPI assigned
- Oct 23, 2025
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | IA | Yes |
Addresses
Primary practice location
815 Tower Park Dr
Waterloo, IA 50701-9027
Mailing address
815 Tower Park Dr
Waterloo, IA 50701-9027
Phone (319) 217-9256
Other providers in Waterloo, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 23, 2025. 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.