Individual
KAITLYNE FISHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4721 S CLIFF AVE STE 103, INDEPENDENCE, MO 64055-6969
(816) 499-9663
Mailing address
613 RICHFIELD RD APT A, LIBERTY, MO 64068-2541
(816) 591-0448
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
12/28/2020
Last updated
12/28/2020
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