Individual
MICAYLA BRIANNE SANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
233 E CAMINO ST, SPRINGFIELD, MO 65810-1708
(417) 430-5792
Mailing address
233 E CAMINO ST, SPRINGFIELD, MO 65810-1708
(417) 430-5792
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
07/09/2024
Last updated
07/09/2024
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