Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician |
NPI | 1003350737 |
---|---|
Provider Name | Ms. Laura Healy |
First Address | Burlington, WA 98233-3320 |
Second Address | Burlington, WA 98233-3320 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/12/2016 |
Last Update Date | 15/12/2016 |