Individual
TASHA MARIE MCKISSACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1492 S SILICON WAY STE A, ST. GEORGE, UT 84770
(435) 275-8911
(435) 200-9442
Mailing address
1492 S SILICON WAY STE A, ST GEORGE, UT 84770-7156
(435) 275-8911
(435) 200-9442
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
13276557-2506
UT
Other
Enumeration date
06/27/2017
Last updated
03/11/2024
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