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NPI Code Detail

MEDICARE: IEMORLICE THOU

MEDICARE: IEMORLICE THOU
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1144177759
Entity Type Code : Individual
Provider Name (Legal Business Name) : IEMORLICE THOU
Provider Business Mailing Address
First Line : 206 COTTAGE GROVE RD APT 307
Second Line :
City : MADISON
State : WI
Zip : 53716-1185
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 901 WHALEN RD
Second Line :
City : VERONA
State : WI
Zip : 53593-1765
Country : US
Telephone Number : 608-229-1643
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/12/2026
Last Update Date : 03/12/2026

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Directions to “ IEMORLICE THOU ” Practice Location

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