Most Relevant Information
Provider Data
| NPI Number: | 1003450305 |
| Provider Name: | JOHANNA HAERTER RBT |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: | RBT-19-101134 |
Most Important Dates
| Enumeration Date: | 10/30/2019 |
| Last Updated: | 10/30/2019 |
Provider Practice Location
4725 AMBER VALLEY PKWY S STE B
FARGO
ND
581048614
Practice Location Phone/Fax
| Phone: | 7014780221 |
| Fax: |
Provider Mailing Location
4725 AMBER VALLEY PKWY S STE B
FARGO
ND
581048614
Provider Mailing Phone/Fax
| Phone: | 7014780221 |
| Fax: |