Individual
MRS. KAYLA IRENE TERRIQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, BCBA
Contact information
Practice address
1496 W MEQUON RD, MEQUON, WI 53092-3268
(414) 881-8435
Mailing address
2050 LILLY RD, ELM GROVE, WI 53122-1214
(262) 483-1773
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
165-140
WI
Other
Enumeration date
01/10/2017
Last updated
01/10/2017
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