Provider Demographics
NPI:1811477896
Name:STETLER-IOTT, LAURA ANN (MA, BCBA, LBA)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:ANN
Last Name:STETLER-IOTT
Suffix:
Gender:F
Credentials:MA, BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3458 S ALAMEDA ST
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78411-1720
Mailing Address - Country:US
Mailing Address - Phone:361-815-2433
Mailing Address - Fax:
Practice Address - Street 1:3458 S ALAMEDA ST
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-1720
Practice Address - Country:US
Practice Address - Phone:361-815-2433
Practice Address - Fax:361-853-7216
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-18
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
TX3886103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician