Individual
KAYSHA FONSECA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BEHAVIOR TECHNICIAN
Contact information
Practice address
2603 CENTRAL AVE, DODGE CITY, KS 67801-6210
(513) 490-3643
Mailing address
2603 CENTRAL AVE, DODGE CITY, KS 67801-6210
(513) 490-3643
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
04/25/2023
Last updated
04/25/2023
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