Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician |
NPI | 1982373528 |
---|---|
Provider Name | Kellie Wojciechowski |
First Address | Cincinnati, OH 45202-7449 |
Second Address | Edgewood, KY 41017-8120 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/09/2021 |
Last Update Date | 08/09/2021 |