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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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