Individual
CAILA FAUTENBERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
1420 NW GILMAN BLVD STE 2604, ISSAQUAH, WA 98027-5394
(805) 668-8961
(208) 416-6922
Mailing address
2559 S WATERBURY LN, BOISE, ID 83706-4981
(805) 668-8961
(208) 416-6922
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
CB60775476
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CB60775476
—
WA
Enumeration date
09/06/2018
Last updated
09/06/2018
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