Individual
KATELYNNE CHANTHAVONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A., BCBA, LBA
Contact information
Practice address
110 2ND ST SW STE 140, AUBURN, WA 98001-5203
(425) 802-9336
Mailing address
25335 119TH PL SE, KENT, WA 98030-6646
(425) 802-9336
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BACB593119
WA
106E00000X
Assistant Behavior Analyst
AB61182370
WA
106S00000X
Behavior Technician
—
—
Other
Enumeration date
12/05/2020
Last updated
01/10/2022
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