Individual
LISA CAGLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2404 W 8TH ST, COFFEYVILLE, KS 67337-2931
(620) 330-9036
Mailing address
2404 W 8TH ST, COFFEYVILLE, KS 67337-2931
(620) 330-9036
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
08/19/2022
Last updated
05/03/2024
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