Provider Demographics
NPI:1457826802
Name:HUPP, JOSIE MARIE (MED, BCBA)
Entity Type:Individual
Prefix:MRS
First Name:JOSIE
Middle Name:MARIE
Last Name:HUPP
Suffix:
Gender:F
Credentials:MED, BCBA
Other - Prefix:MISS
Other - First Name:JOSIE
Other - Middle Name:MARIE
Other - Last Name:KUNZE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MED, BCBA
Mailing Address - Street 1:35576 WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:BOONEVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:50038-3301
Mailing Address - Country:US
Mailing Address - Phone:515-564-9646
Mailing Address - Fax:
Practice Address - Street 1:1860 NW 118TH ST
Practice Address - Street 2:
Practice Address - City:CLIVE
Practice Address - State:IA
Practice Address - Zip Code:50325-8278
Practice Address - Country:US
Practice Address - Phone:515-402-4130
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-11
Last Update Date:2019-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst