Individual
BREANNA KOEHLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
629 PAWNEE ST, LEAVENWORTH, KS 66048-1447
(785) 256-9096
Mailing address
18001 SW 46TH RD, DE KALB, MO 64440-4122
(816) 244-9072
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
04/01/2024
Last updated
04/01/2024
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