Individual
MRS. MYRNA ASTRAEA KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSABA, BCBA, LBA
Contact information
Practice address
8019 NE 13TH AVE, VANCOUVER, WA 98665-9604
(541) 974-5778
Mailing address
8019 NE 13TH AVE, VANCOUVER, WA 98665-9604
(541) 974-5778
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BA61552219
WA
106E00000X
Assistant Behavior Analyst
AB61429916
WA
Other
Enumeration date
04/28/2017
Last updated
06/12/2024
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