Individual
HEAVYN-MARIE SOUDAPHONE HATSABOUTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1570 WILMINGTON DR STE 220, DUPONT, WA 98327-8773
(206) 453-4882
Mailing address
4155 129TH PL SE APT A303, BELLEVUE, WA 98006-1378
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
02/21/2020
Last updated
02/21/2020
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