Individual
CARISSA POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
212 N G ST, TACOMA, WA 98403-3414
(253) 341-0763
Mailing address
212 N G ST APT 10, TACOMA, WA 98403-3414
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
01/04/2018
Last updated
01/04/2018
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