Individual
BLAISE IGNACIOUS RONNAU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
971 E WICHITA AVE, RUSSELL, KS 67665-2444
(785) 657-7464
Mailing address
2776 OUTRIDER CT, CHEYENNE, WY 82009-7512
(307) 365-4475
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
10/26/2021
Last updated
10/26/2021
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