Kierstin Clark
Individual provider Active NPI Behavior Technician · Newton, IL
NPI 1255155693 · NPPES record last updated Nov 12, 2024
Key facts
- NPI
- 1255155693
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- Practice address
- 900 Liberty Ave
Newton, IL 62448-1808 - Phone
- (618) 783-7529
- NPI assigned
- Nov 12, 2024
- 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 | Yes |
Addresses
Primary practice location
900 Liberty Ave
Newton, IL 62448-1808
Mailing address
10389 N 700TH St
Newton, IL 62448-3460
Phone (618) 554-7944
Other providers in Newton, IL
- Pamela Sue Briscoe
- Alyssa Burnett
- Debra Darlene Cantrell
- Champion Fitness, Inc
- Caitlin Chapman
- Haylee Ann Cohorst
- Charles T Coleman
- Matthew A Cooley
- County of Jasper
- County of Jasper
All providers in Newton, IL · Behavior Technician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 12, 2024. 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.