Individual
KAITLYN C POYTHRESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, BCBA, LBA
Contact information
Practice address
614 E ADAMS ST, JACKSON, MO 63755-2150
(573) 243-9501
Mailing address
1629 JENNIFER DR, JACKSON, MO 63755-8708
(573) 450-2999
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
1-23-67680
—
103K00000X
Behavior Analyst
Primary
2023046696
MO
Other
Enumeration date
04/24/2024
Last updated
11/06/2024
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