Individual
DIANA BROCKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4014 52ND ST NE, TACOMA, WA 98422-1980
(206) 618-4673
Mailing address
4014 52ND ST NE, TACOMA, WA 98422-1980
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
06/03/2024
Last updated
06/03/2024
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