Provider Demographics
NPI:1801574280
Name:KAISER, KARSYN BRIN
Entity type:Individual
Prefix:
First Name:KARSYN
Middle Name:BRIN
Last Name:KAISER
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 1:2958 CENTERVILLE RD
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61102-3709
Mailing Address - Country:US
Mailing Address - Phone:181-529-8181
Mailing Address - Fax:
Practice Address - Street 1:5801 MOUNT PLEASANT LN
Practice Address - Street 2:
Practice Address - City:BELLEVILLE
Practice Address - State:IL
Practice Address - Zip Code:62223-3944
Practice Address - Country:US
Practice Address - Phone:314-560-7063
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-06
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst