Individual
TARA ELIZABETH CASSIDY BUETTNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
1511 W MAIN AVE # 200, DE PERE, WI 54115-9556
(920) 278-0191
Mailing address
1575 ALLOUEZ AVE, GREEN BAY, WI 54311-5639
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
09/13/2023
Last updated
09/13/2023
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