Individual
KAYLA STASTNY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1237 W DIVIDE AVE STE 5, BISMARCK, ND 58501-1208
(701) 328-8851
Mailing address
1237 W DIVIDE AVE STE 5, BISMARCK, ND 58501-1208
(701) 328-8851
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BMOD
ND
Other
Enumeration date
09/01/2020
Last updated
09/01/2020
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