Individual
AMANDA L HUSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4020 WHEATON WAY, BREMERTON, WA 98310-3566
(907) 521-0890
Mailing address
300 W SWANSON AVE, WASILLA, AK 99654-6844
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-19-93937
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RBT-19-93937
RBT
WA
Enumeration date
07/29/2019
Last updated
07/29/2019
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