Individual
KENZIE RUTH ISOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
214 FERREL ST, PLATTE CITY, MO 64079-9511
(816) 469-5162
Mailing address
32419 215TH ST, EASTON, KS 66020-7221
(405) 538-9767
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
10/02/2023
Last updated
10/02/2023
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