KASSIDY DIANE WAGNER

EAGLE, ID
NPI1376197723
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy103K00000X Behavior Analyst
(Licence: ID  1-23-68300)
Enumeration Date2019-07-24
Last Update Date2023-12-21
Business Address
Mrs. KASSIDY DIANE WAGNER BCBA
449 S FITNESS PL
EAGLE, ID 83616-6828
Phone number: 208-957-6301
Mailing Address
Mrs. KASSIDY DIANE WAGNER BCBA
449 S FITNESS PL
EAGLE, ID 83616-6828
Phone number: 208-957-6301
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