Individual
IRELAND SUSANNAH BOSWORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4624 WALLER RD E, TACOMA, WA 98443-1418
(253) 252-9293
Mailing address
4624 WALLER RD E, TACOMA, WA 98443-1418
(253) 252-9293
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
CB70022307
WA
Other
Enumeration date
10/18/2025
Last updated
10/18/2025
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