Individual
ALYSSA KASSANDRA MORA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
901 CALEDONIA ST, LA CROSSE, WI 54603-2616
(608) 495-2173
Mailing address
433 10TH ST N, LA CROSSE, WI 54601-3466
(608) 495-2173
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
05/24/2018
Last updated
05/24/2018
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