Individual
BROOKE VAN AUSDLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8282 28TH CT NE, SUITE A, LACEY, WA 98516-7162
(360) 915-6868
(360) 547-6470
Mailing address
8282 28TH CT NE, SUITE A, LACEY, WA 98516-7162
(360) 915-6868
(360) 547-6470
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
03/18/2014
Last updated
03/18/2014
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