Individual
HALEY CRISOSTOMO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4360 FREEMONT ST NE, LACEY, WA 98516-1337
(360) 884-5403
Mailing address
4360 FREEMONT ST NE, LACEY, WA 98516-1337
(360) 884-5403
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
WA
Other
Enumeration date
04/01/2024
Last updated
04/01/2024
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