Individual
SIVAN SO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
22845 SE 1ST PL APT 215, SAMMAMISH, WA 98074-5038
(805) 668-8961
(208) 416-6922
Mailing address
22845 SE 1ST PL APT 215, SAMMAMISH, WA 98074-5038
(805) 668-8961
(208) 416-6922
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BA61054733
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-20-41787
B.A.C.B.
—
01
—
BA61054733
WASHINGTON DEPARTMENT OF HEALTH
WA
Enumeration date
03/25/2020
Last updated
03/25/2020
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