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Evan Kotter

Behavior Technician in La Crosse, WI. Individual provider (NPI-1).

NPI number1962079178
StatusActive
Last updated in NPPESJun 7, 2021

Details

NPI
1962079178
Entity type
Individual (NPI-1)
Name
Evan Kotter
Sex
Male
Sole proprietor
Yes
Enumeration date
Jun 7, 2021
Certification date
Jun 7, 2021
Last updated
Jun 7, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
106S00000X Behavior Technician––Yes

Practice location

901 Caledonia St
La Crosse, WI 54603-2616

Phone 715-853-6501

Mailing address

1509 Southcross Dr W
Burnsville, MN 55306-6945

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