Individual
MRS. AMY KROCZAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
105B 182ND PL SW, BOTHELL, WA 98012-6204
(425) 736-2816
Mailing address
105B 182ND PL SW, BOTHELL, WA 98012-6204
(425) 736-2816
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-18-32892
BACB
—
01
—
BA60973206
WASHINGTON STATE DEPARTMENT OF HEALTH
WA
Enumeration date
01/14/2020
Last updated
01/14/2020
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