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Individual

SERENA DANVILLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
275 LEWIS PL, SEDRO WOOLLEY, WA 98284-4394
(360) 318-4700
Mailing address
2600 ALABAMA ST STE B, BELLINGHAM, WA 98229-4055
(360) 318-4700

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
WA
106S00000X
Behavior Technician
CB61002326
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2041449
WA
Enumeration date
02/25/2021
Last updated
10/03/2022
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