Individual
KEIYANA HURT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
27023 164TH AVE SE, COVINGTON, WA 98042-8241
(253) 639-7146
Mailing address
2445 S 222ND ST APT G304, DES MOINES, WA 98198-8845
(425) 773-0457
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
CBT.CB.61196684
WA
Other
Enumeration date
02/02/2022
Last updated
02/02/2022
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