Provider Demographics
NPI:1790356566
Name:BUNTING, KATIE (MS BCBA)
Entity Type:Individual
Prefix:MS
First Name:KATIE
Middle Name:
Last Name:BUNTING
Suffix:
Gender:F
Credentials:MS BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14726 195TH ST
Mailing Address - Street 2:
Mailing Address - City:WHAT CHEER
Mailing Address - State:IA
Mailing Address - Zip Code:50268-8618
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:13300 HICKMAN RD STE 110
Practice Address - Street 2:
Practice Address - City:CLIVE
Practice Address - State:IA
Practice Address - Zip Code:50325-8616
Practice Address - Country:US
Practice Address - Phone:515-987-8835
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-02
Last Update Date:2021-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst