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Individual

KERRY KRISTINE LEISE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
9623 BRYCE DR # 19, WACO, TX 76712-3218
(512) 641-4020
Mailing address
9529 W FM 93, BELTON, TX 76513-8321
(254) 444-3949

Taxonomy

Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
TX

Other

Enumeration date
06/06/2023
Last updated
06/06/2023
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