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1972074011
TAVIANCE BENET LASTER
LAKEWOOD, WA
NPI
1972074011
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2018-12-16
Last Update Date
2021-01-29
Business Address
TAVIANCE BENET LASTER
10015 LAKEWOOD DR SW
LAKEWOOD, WA 98499-3838
Phone number: 253-358-0888
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Mailing Address
TAVIANCE BENET LASTER
16782 VON KARMAN AVE STE 11
IRVINE, CA 92606-2417
Phone number: 619-550-6368
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