Individual
CASSANDRA WALLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, BCBA, LBA
Contact information
Practice address
5809 NE 71ST AVE, UNIT 12, VANCOUVER, WA 98661-9866
(360) 229-2029
Mailing address
5809 NE 71ST AVE UNIT 12, VANCOUVER, WA 98661-1944
(360) 229-2029
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-16-24068
WA
Other
Enumeration date
03/19/2015
Last updated
08/25/2022
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