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General NPI Number Information
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NPI Number | 1821548645
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Entity Type | Individual
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Provider Name | AUSTIN FARRELL ROBERTS M.ED, BCBA, LABA
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Gender | Male
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Dates
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Enumeration Date | 10/04/2016
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Last Update Date | 05/03/2023
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Provider Practice Location Address
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Address Line | 20818 44TH AVE W STE 190
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City | LYNNWOOD
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State | WA
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Zip | 98036-7745
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Country | US
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Telephone | 425-673-6908
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Fax |
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Provider Business Mailing Address
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Address Line | 23601 56TH AVE W UNIT 4104
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City | MOUNTLAKE TERRACE
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State | WA
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Zip | 98043-5268
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Country | US
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Telephone | 425-275-6272
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | CG60703536
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License Number State | WA
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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 | AB61427616
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License Number State | WA
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