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Individual

KAYLEIGH KNUDSEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
13322 I ST, OMAHA, NE 68137-1111
(402) 230-5861
(531) 200-5808
Mailing address
13322 I ST, OMAHA, NE 68137-1111
(402) 230-5861
(531) 200-5808

Taxonomy

Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
0-20-11251
106S00000X
Behavior Technician
RBT-19-76726
NE
106S00000X
Behavior Technician

Other

Enumeration date
01/08/2019
Last updated
11/16/2020
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