Individual
ALYSSA NICOLE CHILDERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3125 DOVER ST APT 11, LONGVIEW, WA 98632-1962
(971) 266-7806
Mailing address
3125 DOVER ST APT 11, LONGVIEW, WA 98632-1962
(971) 266-7806
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
101366194
UNITED HEALTHCARE
WA
Enumeration date
03/12/2021
Last updated
03/12/2021
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