Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst | AB60980295 | WA |
NPI | 1053620369 |
---|---|
Provider Name | Guadalupe Estela Herrera |
First Address | Seattle, WA 98199-3245 |
Second Address | Dupont, WA 98327-8773 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2010 |
Last Update Date | 04/11/2019 |