| NPI | 1154611143 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AUDRA K JENSEN Behavior Analyst 360-524-3440 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2011-04-12 |
| Last Update Date | 2012-01-10 |