Individual
EMILY BACA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8282 28TH CT NE STE A, LACEY, WA 98516-7162
(360) 915-6868
Mailing address
8282 28TH CT NE STE A, LACEY, WA 98516-7162
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
KROAN0361317
BLUECROSS BLUESHIELD
—
Enumeration date
04/01/2019
Last updated
04/01/2019
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