Healthcare Provider Details

I. General information

NPI: 1073747325
Provider Name (Legal Business Name): MS. KRISTINA BETH GUNIA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MRS. KRISTINA BETH GUNIA-BARI

II. Dates (important events)

Enumeration Date: 05/14/2009
Last Update Date: 05/14/2024
Certification Date: 05/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1106 N 155TH ST
BASEHOR KS
66007-7100
US

IV. Provider business mailing address

733 WEST SPRUCE STREET
JUNCTION CITY KS
66441
US

V. Phone/Fax

Practice location:
  • Phone: 913-662-7071
  • Fax:
Mailing address:
  • Phone: 912-271-6196
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number144
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: