Organization
BLUE WATER BEHAVIORAL CONSULTING LLC
Active
Organization
BLUE WATER BEHAVIORAL CONSULTING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RACHEL DANIELLE WAGNER MS, LBA, BCBA (CEO)
(360) 333-5684
Entity
Organization
Contact information
Practice address
851 SE PIONEER WAY, 201, OAK HARBOR, WA 98277
(360) 333-5684
(360) 230-3272
Mailing address
1777 S. BURLINGTON BLVD, #465, BURLINGTON, WA 98233
(360) 333-5684
(360) 230-3272
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
251S00000X
Community/Behavioral Health Agency
1-10-7191
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2041449
—
WA
Enumeration date
02/16/2014
Last updated
07/30/2020
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