Individual
MAKAYLA SAMPLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8282 28TH CT NE STE A, LACEY, WA 98516-7162
(253) 732-0385
Mailing address
8282 28TH CT NE STE A, LACEY, WA 98516-7162
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
04/11/2019
Last updated
04/11/2019
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