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Individual

AMMELIA ZOIE DANSE' WHITEHEAD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
QMHP-A, QMHP-C, BS

Contact information

Practice address
18311 BOTHELL EVERETT HWY STE 260, BOTHELL, WA 98012-5233
(206) 437-5412
Mailing address
1304 BRUSKRUD RD APT E205, EVERETT, WA 98208-4120
(703) 825-0225

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
WA

Other

Enumeration date
03/08/2023
Last updated
03/08/2023
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