Individual
JERUSELA TEJA LACHELLE HOUSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
720 S 333RD ST STE 130, FEDERAL WAY, WA 98003-7357
(253) 766-5156
Mailing address
3310 DEER ISLAND DR E, LAKE TAPPS, WA 98391-9493
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
09/26/2022
Last updated
09/26/2022
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