Individual
KYLIE RENEE STAGGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BA, RBT
Contact information
Practice address
5215 COMMERCE CROSSINGS DR, LOUISVILLE, KY 40229-2183
(502) 251-7002
(317) 520-8200
Mailing address
3500 DEPAUW BLVD STE 3070, INDIANAPOLIS, IN 46268-6135
(855) 324-0885
(317) 520-8200
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-19-86618
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RBT-19-86618
RBT CERTIFICATE
—
Enumeration date
06/21/2019
Last updated
06/21/2019
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