Individual
ALEXIS TELLEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
3680 S CEDAR ST STE A, TACOMA, WA 98409-5728
(206) 313-8840
Mailing address
3240 30TH ST SE, PUYALLUP, WA 98374-2088
(505) 435-7997
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
111524501
—
WA
Enumeration date
01/29/2024
Last updated
02/03/2024
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