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General NPI Number Information
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NPI Number | 1992444335
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Entity Type | Organization
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Legal Business Name | STRIDES THERAPEUTIC SERVICES
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Dates
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Enumeration Date | 06/02/2022
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Last Update Date | 06/02/2022
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Provider Practice Location Address
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Address Line | 5700 NE 82ND AVE UNIT G38
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City | VANCOUVER
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State | WA
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Zip | 98662-9431
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Country | US
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Telephone | 435-668-8590
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Fax |
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Provider Business Mailing Address
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Address Line | 5700 NE 82ND AVE UNIT G38
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City | VANCOUVER
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State | WA
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Zip | 98662-9431
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Country | US
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Telephone | 435-668-8590
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Fax |
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Authorized Official
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Title or Position | OWNER/ CLINICAL SUPERVISOR
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Name | ELSIE HERRING
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Credential | BCBA LBA
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Telephone | 435-668-8590
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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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