Individual
ELIZABETH WHITEHEAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
20818 44TH AVE W STE 270, LYNNWOOD, WA 98036-7709
(425) 712-0802
Mailing address
20818 44TH AVE W STE 270, LYNNWOOD, WA 98036-7709
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
AB60812254
WA
106S00000X
Behavior Technician
CB60765092
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2063578
—
WA
Enumeration date
07/22/2016
Last updated
12/22/2020
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