Healthcare Provider Details

I. General information

NPI: 1629981865
Provider Name (Legal Business Name): KINVARA ABA IA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5550 WILD ROSE LN STE 400
WEST DES MOINES IA
50266-5351
US

IV. Provider business mailing address

5550 WILD ROSE LN STE 400
WEST DES MOINES IA
50266-5351
US

V. Phone/Fax

Practice location:
  • Phone: 515-676-8211
  • Fax:
Mailing address:
  • Phone: 515-676-8211
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateNULL

VIII. Authorized Official

Name: KAYLA LOPEZ
Title or Position: BCBA
Credential: M.ED, BCBA, LBA, IBA
Phone: 515-676-8211