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Individual

MRS. KAYLA LEE KACZKA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
BCBA

Contact information

Practice address
1740 S GLENSTONE AVE, SUITE S, SPRINGFIELD, MO 65804-1511
(417) 890-1399
(417) 890-1775
Mailing address
1740 S GLENSTONE AVE, SUITE S, SPRINGFIELD, MO 65804-1511
(417) 890-1399
(417) 890-1775

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
2014003096
MO
103K00000X
Behavior Analyst
Primary
2015015158
MO

Other

Enumeration date
02/03/2014
Last updated
05/26/2015
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