Individual
FAYE VICTORIA GAZABAT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA, LBA
Contact information
Practice address
13765 VINTAGE DR SW, PORT ORCHARD, WA 98367-7391
(253) 970-2414
Mailing address
9711 CRESCENT VALLEY DR NW, GIG HARBOR, WA 98332-7555
(817) 454-2841
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BA61370580
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BA61370580
STATE LICENSE
WA
Enumeration date
08/15/2019
Last updated
02/20/2025
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