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General NPI Number Information
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NPI Number | 1417674763
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Entity Type | Organization
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Legal Business Name | BLUE ROSE BEHAVIORAL CONSULTING
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Dates
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Enumeration Date | 10/26/2022
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Last Update Date | 10/26/2022
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Provider Practice Location Address
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Address Line | 507 S 309TH CT
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City | FEDERAL WAY
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State | WA
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Zip | 98003-4068
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Country | US
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Telephone | 253-466-6463
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Fax | 888-255-7921
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Provider Business Mailing Address
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Address Line | 507 S 309TH CT
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City | FEDERAL WAY
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State | WA
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Zip | 98003-4068
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Country | US
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Telephone | 253-466-6463
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Fax | 888-255-7921
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Authorized Official
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Title or Position | OWNER
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Name | JANICE DEANN HANSON
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Credential | BCBA, LBA
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Telephone | 253-466-6463
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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Taxonomy #2
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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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