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Organization
MAGNOLIA BEHAVIOR THERAPY
Active
Organization
MAGNOLIA BEHAVIOR THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MCCULLOUGH CAMPBELL (ADMINISTATOR)
(206) 453-4882
Entity
Organization
Contact information
Practice address
3214 W MCGRAW ST, SUITE 212, SEATTLE, WA 98199-3239
(206) 453-4882
Mailing address
3214 W MCGRAW ST, SUITE 212, SEATTLE, WA 98199-3239
(206) 453-4882
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
CG60618517
WA
Other
Enumeration date
11/24/2015
Last updated
11/24/2015
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