Individual
MRS. KIMBERLIE SUZANNE HAUPT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1417 N MOUNT AUBURN RD, CAPE GIRARDEAU, MO 63701-2171
(573) 271-2540
Mailing address
1015 E ADAMS ST, JACKSON, MO 63755-2219
(573) 270-6786
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
10/02/2019
Last updated
10/02/2019
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