Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician | 17-38424 | GA |
NPI | 1003324716 |
---|---|
Provider Name | Alaina Cowell |
First Address | Seattle, WA 98119-2664 |
Second Address | Seattle, WA 98199 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/01/2018 |
Last Update Date | 30/07/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
071423 | CPH (01) | GA |