Individual
KRISTA T NUGENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
31620 23RD AVE S STE 302, FEDERAL WAY, WA 98003-5064
(206) 592-2756
Mailing address
10835 SE KENT KANGLEY RD APT F5, KENT, WA 98030-7773
(845) 421-2081
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
—
—
106S00000X
Behavior Technician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1980028
—
WA
Enumeration date
08/23/2017
Last updated
02/15/2022
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