Individual
FANTASIA A DAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
16201 E INDIANA AVE STE 3400, SPOKANE VALLEY, WA 99216-2830
(509) 900-3669
Mailing address
1819 E MARSHALL AVE, SPOKANE, WA 99207-5223
(509) 941-6032
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
CB61666532
WA
Other
Enumeration date
03/13/2025
Last updated
12/05/2025
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