Individual
KAJZOO GRACE HANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3515 S ORCHARD ST APT E12, TACOMA, WA 98466-6785
(612) 845-9302
Mailing address
3515 S ORCHARD ST APT E12, TACOMA, WA 98466-6785
(612) 845-9302
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
CB60883859
WA
Other
Enumeration date
08/07/2018
Last updated
08/07/2018
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