Individual
EMILY M DITTOE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CBT
Contact information
Practice address
900 PACIFIC AVE FL 1, EVERETT, WA 98201-4168
(425) 258-7311
Mailing address
PO BOX 3360, PORTLAND, OR 97208-3360
(866) 747-2455
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
CB60791182
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CB60791182
STATE LICENSE
WA
Enumeration date
09/27/2017
Last updated
09/27/2017
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