Individual
TRISTA FERGERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AUTISM SPECIALIST
Contact information
Practice address
2603 CENTRAL AVE, DODGE CITY, KS 67801-6210
(513) 490-3643
Mailing address
509 ANNETTE ST, DODGE CITY, KS 67801-2811
(513) 490-3643
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
00000
KS
106S00000X
Behavior Technician
—
KS
Other
Enumeration date
04/10/2021
Last updated
10/14/2021
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