Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Ethan John Dultz

Individual provider Behavior Technician · NPI 1811646078

Ethan John Dultz is a Behavior Technician in Saint Louis, Missouri. Licensed in Missouri. Registered with an NPI since 2022.

Licensed in
MO
In the registry since
2022
Specialties on file
2
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Practice location Address checks out

9734 Olive Blvd Unit 101
Saint Louis, MO 63132-3253
Phone: (314) 932-2402
Fax: (314) 666-9770
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Behavior Analyst (primary) Taxonomy 103K00000X
Behavior Technician Taxonomy 106S00000X (MO)

Record details

NPI number1811646078
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMarch 23, 2022
Last updated in NPPESOctober 13, 2023
Certification dateOctober 12, 2023

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