Healthcare Provider Details

I. General information

NPI: 1568147098
Provider Name (Legal Business Name): MARISA KATE KUHN RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2023
Last Update Date: 06/21/2023
Certification Date: 06/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2323 W CHESTNUT ST STE 6
ROGERS AR
72756-3520
US

IV. Provider business mailing address

2323 W CHESTNUT ST STE 6
ROGERS AR
72756-3520
US

V. Phone/Fax

Practice location:
  • Phone: 479-346-5459
  • Fax:
Mailing address:
  • Phone: 479-346-5459
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-22-226164
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: