Individual
BREANNA THAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6505 218TH ST SW STE 9, MOUNTLAKE TERRACE, WA 98043-2135
(425) 563-1093
Mailing address
17826 14TH PL W, LYNNWOOD, WA 98037-4033
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
10/31/2017
Last updated
10/31/2017
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