Individual
KYRSTEN DEANN BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
320 6TH ST, RAYMOND, WA 98577-2503
(360) 353-3108
Mailing address
PO BOX 859, RAYMOND, WA 98577-0859
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
10/11/2021
Last updated
09/11/2025
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