Individual
STACY ANN KOSSMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
2500 ELIZABETH BLVD, TWIN FALLS, ID 83301-7508
(719) 459-4006
Mailing address
2500 ELIZABETH BLVD, TWIN FALLS, ID 83301-7508
(719) 459-4006
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-21-52143
ID
Other
Enumeration date
11/17/2021
Last updated
09/28/2023
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