Bryton Anne Kukowski
Behavior Technician in Hermantown, MN. Individual provider (NPI-1).
NPI number1003590902
StatusActive
Last updated in NPPESJun 12, 2023
Details
- NPI
- 1003590902
- Entity type
- Individual (NPI-1)
- Name
- Bryton Anne Kukowski
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 12, 2023
- Certification date
- Jun 12, 2023
- Last updated
- Jun 12, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | – | Yes |
Practice location
4140 Richard AveHermantown, MN 55811-2869
Phone 218-520-3411
Mailing address
4140 Richard AveHermantown, MN 55811-2869
Phone 218-520-3411
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