NPI 1154164408

Sally a Kubasa

Practitioner Behavior Analyst Wauwatosa, WI

Practice location

Address: 2645 N Mayfair Rd STE 130, Wauwatosa, WI 53226-1304
Phone: (414) 256-0077
Fax: (414) 256-0090

Registered specialties

Behavior Analyst Primary

Behavioral Health & Social Service Providers Taxonomy 103K00000X Licence 1243-140 (WI)

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Registry record

NPI: 1154164408
Entity type: Individual
Sex (as registered): Female
NPI issued: 14 Jun 2024
Record last updated: 14 Jun 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.