Individual
KASSANDRA CRISTAL VANSICKLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
17485 N PORTER RD APT L108, MARICOPA, AZ 85138-4731
(999) 999-9999
Mailing address
17485 N PORTER RD APT L108, MARICOPA, AZ 85138-4731
(999) 999-9999
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
AZ
Other
Enumeration date
03/20/2026
Last updated
03/20/2026
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