Organization
AUTISMWAVE THERAPY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL BULLOCK (COO)
(562) 357-5705
Entity
Organization
Contact information
Practice address
13312 SE 262ND ST, KENT, WA 98042-8521
(206) 582-9392
Mailing address
13312 SE 262ND ST, KENT, WA 98042-8521
(206) 582-9392
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
08/17/2021
Last updated
08/17/2021
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