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NPI Code Detail

MEDICARE: KIANNA STANLEY

MEDICARE:   KIANNA  STANLEY
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 : 1578167284
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIANNA STANLEY
Provider Business Mailing Address
First Line : 402B LEGACY PARK
Second Line :
City : RIDGELAND
State : MS
Zip : 39157-4315
Country : US
Telephone Number : 769-233-7154
Fax Number : 601-398-0364
Provider Business Practice Location Address
First Line : 402B LEGACY PARK
Second Line :
City : RIDGELAND
State : MS
Zip : 39157-4315
Country : US
Telephone Number : 769-233-7154
Fax Number : 601-398-0364
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/23/2020
Last Update Date : 01/27/2023

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Directions to “ KIANNA STANLEY ” Practice Location

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