Individual
LACEY A KUNGAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4324 N JEFFERSON ST, SPOKANE, WA 99205-1209
(509) 315-8682
Mailing address
4324 N JEFFERSON ST, SPOKANE, WA 99205-1209
(509) 315-8682
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
374700000X
Technician
Primary
—
—
Other
Enumeration date
09/24/2018
Last updated
09/24/2018
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