Individual
MRS. PENNY JANE LATHUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.ED., BCBA
Contact information
Practice address
3849 KLAHANIE DR SE APT 1-101, ISSAQUAH, WA 98029-5720
(206) 380-3009
Mailing address
5436 232ND AVE SE, ISSAQUAH, WA 98029
(206) 380-3009
(425) 837-1982
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
1-10-7087
—
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
07/13/2012
Last updated
12/10/2013
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