Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103K00000X | Behavior Analyst | 1-10-7400 | IL |
N | 103K00000X | Behavior Analyst | ABA-B10167964 | OR |
Y | 103K00000X | Behavior Analyst | BA60799188 | WA |
NPI | 1003100272 |
---|---|
Provider Name | Dr. Amy Katherine Fenwick |
First Address | Spokane, WA 99204-2832 |
Second Address | Spokane, WA 99204-2832 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2011 |
Last Update Date | 24/01/2020 |