Individual
SHELLY ELIZABETH MICHALAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
3044 NW MOUNTAIN VW RD, SILVERDALE, WA 98383-7712
(360) 434-0399
(360) 930-5326
Mailing address
3044 NW MOUNTAIN VW RD, SILVERDALE, WA 98383-7712
(360) 434-0399
(360) 930-5326
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
1-12-1005
WA
103K00000X
Behavior Analyst
1-12-1005
—
103K00000X
Behavior Analyst
Primary
1-12-10145
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12524589
CAQH PROVIDER NUMBER
WA
Enumeration date
02/29/2012
Last updated
03/20/2014
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