Individual
MICHAEL CONNOLLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1826 MARKHAM AVE NE # B, TACOMA, WA 98422-1015
(541) 637-6855
Mailing address
PO BOX 3841, FEDERAL WAY, WA 98063-3841
(541) 637-6855
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
CG60396523
WA
Other
Enumeration date
08/26/2013
Last updated
08/26/2013
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