Individual
KELLY KUENNEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10450 72ND AVE, PLEASANT PRAIRIE, WI 53158-2911
(262) 657-7453
Mailing address
10450 72ND AVE, PLEASANT PRAIRIE, WI 53158-2911
(262) 657-7453
(262) 671-5013
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100054165
—
WI
Enumeration date
05/11/2018
Last updated
05/11/2018
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