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Individual

KORI STAAB

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
24690 MO HWY 92, PLATTE CITY, KS 64079-1966
(785) 410-8426
Mailing address
24690 MO HWY 92, PLATTE CITY, KS 64079-1966
(785) 410-8426

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
RBT-15-09756
106S00000X
Behavior Technician
RBT-17-38877
225A00000X
Music Therapist
Primary
13586

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
13586
MT-BC (MUSIC THERAPIST BOARD CERTIFIED)
05
201230650
KS
01
RBT-17-38877
RBT (REGISTERED BEHAVIOR TECHNICIAN)
Enumeration date
12/21/2017
Last updated
09/13/2021
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