Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 106S00000X | Behavior Technician | RBT-17-38200 | HI |
Y | 225XP0200X | Occupational Therapist - Pediatrics | OT61199588 | WA |
NPI | 1043735277 |
---|---|
Provider Name | Maleena Cregg |
First Address | Kent, WA 98030-7108 |
Second Address | Kent, WA 98030-7108 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/08/2017 |
Last Update Date | 24/07/2021 |