Individual
KAITLYN DAWN SISK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8282 28TH CT NE STE A, LACEY, WA 98516-7162
(360) 819-0354
Mailing address
2570 OCEAN AVE, RAYMOND, WA 98577-4928
(360) 819-0354
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/26/2020
Last updated
08/26/2020
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