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Search › Idaho › 103K00000X

Kassidy Wagner, BCBA

NPI 1376197723 · on the registry since 2019

Practice

Address
449 S Fitness Pl
Eagle, ID 83616
Phone
(208) 957-6301
Fax
(208) 228-0585
Organisation at this address
Ot 4 Kidz, Inc
Ot 4 Kidz, Inc
Inferred from a shared address, not stated in the registry.
Clinicians at this address
48

Registry record

Primary taxonomy
103K00000X
103K00000X
Licence states on file
ID
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2023-12-21

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Idaho