Most Relevant Information
Provider Data
| NPI Number: | 1003590290 |
| Provider Name: | MORGAN BALTAZOR |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 06/09/2023 |
| Last Updated: | 06/09/2023 |
Provider Practice Location
1719 METROPOLITAN AVE
LEAVENWORTH
KS
660481124
Practice Location Phone/Fax
| Phone: | 9132505634 |
| Fax: |
Provider Mailing Location
1719 METROPOLITAN AVE
LEAVENWORTH
KS
660481124
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |