Individual
KYLE MASSEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2620 FORUM BLVD STE E, COLUMBIA, MO 65203-5454
(573) 514-8735
Mailing address
2620 FORUM BLVD STE E, COLUMBIA, MO 65203-5454
(573) 514-8735
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
05/31/2023
Last updated
05/31/2023
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