Individual
MS. SHEALEEN MAIA KENNEDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.ED., BCBA, LBA
Contact information
Practice address
9431 COPPERTOP LOOP NE UNIT 205, BAINBRIDGE ISLAND, WA 98110-3684
(206) 351-1811
Mailing address
PO BOX 4792, ROLLINGBAY, WA 98061-0792
(206) 351-1811
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
1-12-10437
MA
103K00000X
Behavior Analyst
Primary
BA603242577
WA
Other
Enumeration date
03/20/2013
Last updated
11/24/2020
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