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General NPI Number Information
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NPI Number | 1366295529
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Entity Type | Organization
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Legal Business Name | WILLETTS WAY ABA
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Dates
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Enumeration Date | 04/08/2024
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Last Update Date | 04/16/2024
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Provider Practice Location Address
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Address Line | 10019 15TH PL SE
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City | LAKE STEVENS
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State | WA
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Zip | 98258-3830
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Country | US
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Telephone | 818-401-5134
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Fax | 833-992-3922
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Provider Business Mailing Address
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Address Line | 10019 15TH PL SE
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City | LAKE STEVENS
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State | WA
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Zip | 98258-3830
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Country | US
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Telephone | 818-401-5134
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Fax | 833-992-3922
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Authorized Official
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Title or Position | FOUNDER/SENIOR BEHAVIOR ANALYST
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Name | WENDY WILLETT YORK
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Credential | LBA
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Telephone | 818-401-5134
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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