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Individual

AMANDA LEIGH LUDTKE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
19401 40TH AVE W STE 100, LYNNWOOD, WA 98036-5600
(832) 312-3868
Mailing address
1425 BROADWAY # 273, SEATTLE, WA 98122-3854
(832) 312-3868

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
106S00000X
BEHAVIOR TECHNICIAN
Enumeration date
11/04/2022
Last updated
11/04/2022
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