Individual
KAYLEE ERIN BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8815 S TACOMA WAY STE 122, TACOMA, WA 98499-7011
(206) 743-6873
Mailing address
11005 66TH AVE E APT 3, PUYALLUP, WA 98373-4102
(206) 743-6873
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
106E00000X
Assistant Behavior Analyst
AB61473131
WA
106S00000X
Behavior Technician
—
WA
Other
Enumeration date
04/11/2018
Last updated
04/30/2024
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