Individual
KELLEY L KAUTZMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
106 F STREET, COSMOPOLIS, WA 98537
(360) 915-6868
Mailing address
PO BOX 136, WESTPORT, WA 98595-0136
(360) 589-0675
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
106S00000X
Behavior Technician
Primary
—
—
2355S0801X
Speech-Language Assistant
—
—
Other
Enumeration date
06/12/2013
Last updated
12/01/2020
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