Individual
KRISTI MCMILLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1106 N 155TH ST, SUITE B, BASEHOR, KS 66007-7100
(913) 662-7071
(913) 662-7072
Mailing address
1106 N 155TH ST, SUITE B, BASEHOR, KS 66007-7100
(913) 662-7071
(913) 662-7072
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
48-1284001
TAX ID NON-PROFIT
KS
Enumeration date
05/20/2014
Last updated
05/20/2014
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