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NPI Code Detail

MEDICARE: KAYLA KASTNER

MEDICARE: KAYLA KASTNER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1811456296
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAYLA KASTNER
Provider Business Mailing Address
First Line : 1105 W RUSSELL ST
Second Line :
City : SIOUX FALLS
State : SD
Zip : 57104-1322
Country : US
Telephone Number : 605-271-2690
Fax Number :
Provider Business Practice Location Address
First Line : 3721 23RD ST S # 201
Second Line :
City : SAINT CLOUD
State : MN
Zip : 56301-6198
Country : US
Telephone Number : 605-271-2690
Fax Number : 605-271-3956
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/15/2019
Last Update Date : 03/15/2019

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Directions to “ KAYLA KASTNER ” Practice Location

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