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General NPI Number Information
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NPI Number | 1245743848
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Entity Type | Individual
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Provider Name | SASHA KAY BCABA, LABA
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Gender | Female
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Dates
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Enumeration Date | 11/06/2017
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Last Update Date | 01/14/2022
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Provider Practice Location Address
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Address Line | 965 BURTON RAY ST NE
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City | LACEY
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State | WA
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Zip | 98516-7603
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Country | US
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Telephone | 360-605-0163
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Fax |
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Provider Business Mailing Address
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Address Line | 5814 20TH AVE SE
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City | LACEY
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State | WA
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Zip | 98503-2802
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Country | US
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Telephone | 910-922-2330
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106E00000X
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Taxonomy Name | Assistant Behavior Analyst
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License Number | AB61249235
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License Number State | WA
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