Individual
LISA KUBIAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
4201 DEAN LAKES BLVD STE 160, SHAKOPEE, MN 55379-2863
(612) 800-8671
(612) 509-6689
Mailing address
4201 DEAN LAKES BLVD STE 160, SHAKOPEE, MN 55379-2863
(612) 800-8671
(612) 509-6689
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
07/14/2021
Last updated
07/14/2021
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