Individual
LAUREN WISEGARVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
651 STRANDER BLVD STE 105, TUKWILA, WA 98188
(206) 313-8840
Mailing address
2907 HARRIS PL S, SEATTLE, WA 98144-5925
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BA60857327
WA
Other
Enumeration date
03/11/2010
Last updated
08/17/2018
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