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Individual

CODY KAECH I

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
8282 28TH CT NE STE A, LACEY, WA 98516-7162
(617) 458-1166
Mailing address
8282 28TH CT NE STE A, LACEY, WA 98516-7162
(617) 458-1166

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2027980
WA
Enumeration date
06/14/2016
Last updated
06/14/2016
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