Individual
KYLA MATTILA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
602 E PARK AVE, ANACONDA, MT 59711-2469
(406) 880-0673
Mailing address
602 E PARK AVE, ANACONDA, MT 59711-2469
(406) 880-0673
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
10/23/2019
Last updated
10/23/2019
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