Individual
CITLALLI JOAN HERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8725 S 212TH ST, KENT, WA 98031-1921
(425) 658-3016
Mailing address
1831 S 268TH ST UNIT 25, DES MOINES, WA 98198-9251
(818) 214-9519
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
06/13/2022
Last updated
06/13/2022
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