MEDICARE: REID ANDREW METTERT

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
1	106S00000X	Behavior Technician
2	101YM0800X	Mental Health Counselor	109884	IA

General Provider Information

NPI Number	:	1508427584
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REID ANDREW METTERT

Provider Business Mailing Address
First Line	:	927 N 2ND ST STE B
Second Line	:
City	:	CLINTON
State	:	IA
Zip	:	52732-3750
Country	:	US
Telephone Number	:	877-878-6606
Fax Number	:

Provider Business Practice Location Address
First Line	:	210 JONES ST STE H
Second Line	:
City	:	DUBUQUE
State	:	IA
Zip	:	52001-7615
Country	:	US
Telephone Number	:	563-599-1221
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/21/2019
Last Update Date	:	09/20/2021

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Directions to “ REID ANDREW METTERT ” Practice Location

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