Individual
JENNA EIDENMULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3443 LILLY RD NE STE B, OLYMPIA, WA 98506-3091
(360) 456-2237
Mailing address
3443 LILLY RD NE STE B, OLYMPIA, WA 98506-3091
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
05/16/2020
Last updated
05/16/2020
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