Individual
TIMOTHY RAY GULLICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.S., BCBA
Contact information
Practice address
8282 28TH CT NE, SUITE A, LACEY, WA 98516-7162
(253) 569-0072
Mailing address
PO BOX 1091, BUCKLEY, WA 98321-1091
(253) 569-0072
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
CG 60190232
WA
103K00000X
Behavior Analyst
Primary
1-10-7243
—
Other
Enumeration date
02/24/2011
Last updated
08/02/2016
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