Stanley Keith Wacholz, BS BIS

NPI #1548811904 in Hayden Lake, Idaho

Provider Information

NPI Number: 1548811904
Entity Type: Individual
Name: Stanley Keith Wacholz, BS BIS
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Assistant Behavior Analyst
Credential: BS BIS
Enumeration Date: Sep 26, 2019
Last Updated: Sep 26, 2019

Practice Location

Address: 5723 E DODD RD
City: Hayden Lake
State: Idaho
ZIP Code: 83835-9376
Phone: (208) 651-8985

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Assistant Behavior Analyst	106E00000X	Primary

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