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General NPI Number Information
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NPI Number | 1669366134
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Entity Type | Individual
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Provider Name | COURTNEY LYNN CAROLUS
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Gender | Female
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Dates
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Enumeration Date | 06/07/2025
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Last Update Date | 06/07/2025
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Provider Practice Location Address
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Address Line | 1010 S 336TH ST STE 108
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City | FEDERAL WAY
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State | WA
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Zip | 98003-7354
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Country | US
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Telephone | 253-350-4465
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Fax |
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Provider Business Mailing Address
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Address Line | 3318 108TH AVE E
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City | EDGEWOOD
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State | WA
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Zip | 98372-2007
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Country | US
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Telephone | 253-905-2532
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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 | 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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