| Black Hills Aba, Llc | |
|
24204 Se 263rd Pl Maple Valley WA 98038-7109 | |
| (425) 221-9260 | |
| Not Available |
| Full Name | Black Hills Aba, Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 24204 Se 263rd Pl, Maple Valley, Washington |
| Authorized Official Name and Position | Monika Haffner (OWNER) |
| Authorized Official Contact | 4252219260 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Black Hills Aba, Llc 24204 Se 263rd Pl Maple Valley WA 98038-7109 Ph: (425) 221-9260 | Black Hills Aba, Llc 24204 Se 263rd Pl Maple Valley WA 98038-7109 Ph: (425) 221-9260 |
| NPI Number | 1972199289 |
|---|---|
| Provider Enumeration Date | 12/21/2020 |
| Last Update Date | 12/21/2020 |
| Certification Date | 12/21/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972199289 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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