Most Relevant Information
Provider Data
| NPI Number: | 1003324351 |
| Provider Name: | KATHRYN WISE RBT |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: | RBT-16-18059 |
Most Important Dates
| Enumeration Date: | 01/19/2018 |
| Last Updated: | 01/19/2018 |
Provider Practice Location
3001 MISSION OAKS BLVD UNIT A
CAMARILLO
CA
930128710
Practice Location Phone/Fax
| Phone: | 8053835566 |
| Fax: | 8886590031 |
Provider Mailing Location
3001 MISSION OAKS BLVD UNIT A
CAMARILLO
CA
930128710
Provider Mailing Phone/Fax
| Phone: | 8053835566 |
| Fax: | 8886590031 |