Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst |
NPI | 1003468224 |
---|---|
Provider Name | Bae Lee |
First Address | Bothell, WA 98012-6555 |
Second Address | Everett, WA 98201-4425 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/07/2019 |
Last Update Date | 09/07/2019 |