Healthcare Provider Details

I. General information

NPI: 1326810391
Provider Name (Legal Business Name): SIMONE ALEXIS MAZILU BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SIMONE ALEXIS NEAL CBT

II. Dates (important events)

Enumeration Date: 10/24/2023
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 N 143RD ST
SEATTLE WA
98133-6803
US

IV. Provider business mailing address

7914 110TH AVE SE APT 606
NEWCASTLE WA
98056-1674
US

V. Phone/Fax

Practice location:
  • Phone: 206-914-9219
  • Fax:
Mailing address:
  • Phone: 719-201-1321
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberBA70094958
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: