Individual
AMIA LANAE CROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CBT
Contact information
Practice address
8811 S TACOMA WAY STE 206, LAKEWOOD, WA 98499-4595
(425) 217-1140
Mailing address
8811 S TACOMA WAY STE 206, LAKEWOOD, WA 98499-4595
(425) 217-1140
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
CB61111671
WA
106S00000X
Behavior Technician
Primary
CB61111671
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
WDL65RR5203B
—
WA
Enumeration date
03/16/2021
Last updated
03/22/2021
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