Individual
KY KANAMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BCBA
Contact information
Practice address
1892 E 600TH RD, LECOMPTON, KS 66050-4054
(972) 207-2565
Mailing address
1892 E 600TH RD, LECOMPTON, KS 66050-4054
(972) 207-2565
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
04/22/2025
Last updated
04/22/2025
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