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NPI Code Detail

MEDICARE: LAKOTA KASWORM BCBA

MEDICARE: LAKOTA KASWORM BCBA
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 TechnicianRBT-20-113658AR
2103K00000XBehavior Analyst1-21-56265AR

General Provider Information

NPI Number : 1598399875
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAKOTA KASWORM BCBA
Provider Business Mailing Address
First Line : 5704 EUPER LN STE 100
Second Line :
City : FORT SMITH
State : AR
Zip : 72903-3256
Country : US
Telephone Number : 479-242-4480
Fax Number : 405-336-3008
Provider Business Practice Location Address
First Line : 5704 EUPER LN STE 100
Second Line :
City : FORT SMITH
State : AR
Zip : 72903-3256
Country : US
Telephone Number : 479-242-4480
Fax Number : 405-336-3008
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/26/2020
Last Update Date : 01/11/2022

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Directions to “ LAKOTA KASWORM BCBA” Practice Location

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