Individual
JOANNA RAE MAGGIACOMO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BT
Contact information
Practice address
27023 164TH AVE SE, COVINGTON, WA 98042-8241
(253) 631-0808
Mailing address
27023 164TH AVE SE, COVINGTON, WA 98042-8241
(253) 631-0808
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
06/04/2020
Last updated
06/04/2020
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