Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician |
NPI | 1003312398 |
---|---|
Provider Name | Stephanie Nicole Wright |
First Address | Sultan, WA 98294-7710 |
Second Address | Seattle, WA 98199-3239 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2018 |
Last Update Date | 04/04/2018 |