Individual
JULIA ANN BACCUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6330 CAPITOL BLVD SE, TUMWATER, WA 98501-5205
(360) 915-6934
Mailing address
3443 LILLY RD NE STE B, OLYMPIA, WA 98506-3091
(360) 456-2237
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BA61219525
WA
106S00000X
Behavior Technician
—
WA
Other
Enumeration date
04/24/2018
Last updated
10/06/2021
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