Kayla Jeannette Graves

Individual provider Active NPI Behavior Technician · Malden, MO

NPI 1639733777 · NPPES record last updated Apr 24, 2019

Key facts

NPI
1639733777
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
1905 North Douglas
Malden, MO 63863-2110
Phone
(573) 276-5257
NPI assigned
Apr 24, 2019
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Yes

Addresses

Primary practice location

1905 North Douglas
Malden, MO 63863-2110

Mailing address

1905 North Douglas
Malden, MO 63863-2110
Phone (573) 276-5257

Other providers in Malden, MO

All providers in Malden, MO · Behavior Technician in Missouri

Sources for this page

Verify at the official NPI Registry.