Organization
AUTISM COACHING, CONSULTING, AND TRAINING, LLC
Active
Other names
AUTISM COACHING, CONSULTING, AND TRAINING, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHANE KH MIRAMONTEZ PHD, BCBA (OWNER, CONSULTANT)
(206) 930-7116
Entity
Organization
Contact information
Practice address
676 LOVELL AVE NW, BAINBRIDGE ISLAND, WA 98110
(206) 930-7116
Mailing address
676 LOVELL AVE NW, BAINBRIDGE ISLAND, WA 98110-2714
(206) 930-7116
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
604-132-315
UBI
WA
Enumeration date
06/08/2017
Last updated
07/21/2022
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