Individual
BLAIR STACY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9153 W 133RD ST, OVERLAND PARK, KS 66213-4333
(913) 257-5185
Mailing address
9153 W 133RD ST, OVERLAND PARK, KS 66213-4333
(913) 257-5185
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-22-59940
KS
106S00000X
Behavior Technician
RBT-19-99635
KS
Other
Enumeration date
10/18/2019
Last updated
08/18/2022
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