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General NPI Number Information
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NPI Number | 1700657921
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Entity Type | Organization
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Legal Business Name | KALEIDOSCOPE LLC
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Dates
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Enumeration Date | 01/16/2024
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Last Update Date | 01/16/2024
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Provider Practice Location Address
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Address Line | 14205 SE 36TH PLACE SUITE 100
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City | BELLEVUE
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State | WA
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Zip | 98006
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Country | US
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Telephone | 206-245-4382
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Fax | 855-560-0522
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Provider Business Mailing Address
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Address Line | 12819 SE 38TH ST # 284
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City | BELLEVUE
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State | WA
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Zip | 98006-1326
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Country | US
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Telephone | 206-245-4382
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Fax | 855-560-0522
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Authorized Official
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Title or Position | OWNER
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Name | MICHELLE SARAH WOOD
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Credential | BCBA/ LBA
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Telephone | 206-245-4382
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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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