Individual
HOLLY L BAYLESS DA COSTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3562 A ST, TACOMA, WA 98418-7902
(253) 376-4636
Mailing address
3562 A ST, TACOMA, WA 98418-7902
(253) 376-4636
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
06/02/2019
Last updated
06/02/2019
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