Individual
KATHRYN BOEHM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
644 HAMLET DR, PORT ORANGE, FL 32127-5986
(386) 871-7159
Mailing address
644 HAMLET DR, PORT ORANGE, FL 32127-5986
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
—
—
Other
Enumeration date
11/29/2017
Last updated
11/29/2017
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