Individual
KYLA M SZELAG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
19800 VILLAGE OFFICE CT STE 104, BEND, OR 97702-1813
(541) 480-2570
Mailing address
2007 NE ZACHARY CT APT 2, BEND, OR 97701-5327
(541) 771-9140
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1942537444
—
OR
Enumeration date
01/27/2018
Last updated
01/27/2018
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