Provider Demographics
NPI:1326890849
Name:ACHZIGER, KIYAH FAITH
Entity Type:Individual
Prefix:
First Name:KIYAH
Middle Name:FAITH
Last Name:ACHZIGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1719 N ATLANTIC ST
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99205-4804
Mailing Address - Country:US
Mailing Address - Phone:800-781-5536
Mailing Address - Fax:
Practice Address - Street 1:1719 N ATLANTIC ST
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99205-4804
Practice Address - Country:US
Practice Address - Phone:800-781-5536
Practice Address - Fax:208-620-3985
Is Sole Proprietor?:No
Enumeration Date:2024-04-05
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACB61528568106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician