Individual
MRS. KAITLAN ELIZABETH COLLIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
691 W KAMILCHE LN, SHELTON, WA 98584-7701
(832) 212-2615
Mailing address
691 W KAMILCHE LN, SHELTON, WA 98584-7701
(832) 212-2615
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-15-19559
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-15-19559
BACB
TX
Enumeration date
05/18/2014
Last updated
10/20/2023
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