Individual
KAZUKO GRACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6910 SILVERHEEL ST, SHAWNEE, KS 66226-5316
(913) 405-4550
Mailing address
6910 SILVERHEEL ST, SHAWNEE, KS 66226-5316
(816) 509-8924
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-18-67042
—
Other
Enumeration date
10/02/2018
Last updated
01/26/2023
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