Individual
KAYLA ELIZABETH VICE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
919 S CENTRAL AVE, FAIRBORN, OH 45324-3804
(336) 339-3521
Mailing address
1673 KEN KLARE DR, BEAVERCREEK, OH 45432-1911
(336) 339-3521
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
BACB359377
OH
Other
Enumeration date
04/21/2021
Last updated
04/21/2021
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