| |
9307 N Lake Dr Sw Lakewood WA 98498-1135 | |
(253) 370-8173 | |
Not Available |
Full Name | |
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Speciality | Behavior Analyst |
Location | 9307 N Lake Dr Sw, Lakewood, Washington |
Authorized Official Name and Position | Jesika Miller (BOARD CERTIFIED BEHAVIOR ANALYST) |
Authorized Official Contact | 2533444390 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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9307 N Lake Dr Sw Lakewood WA 98498-1135 Ph: (253) 370-8173 | 9307 N Lake Dr Sw Lakewood WA 98498-1135 Ph: (253) 370-8173 |
NPI Number | 1477010825 |
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Provider Enumeration Date | 02/21/2019 |
Last Update Date | 05/30/2019 |
Identifier | Type | State | Issuer |
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1477010825 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
Paul Kenneth Henry Med Lmhc Ps Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 9101 Bridgeport Way Sw Ste D2, Lakewood, WA 98499 Phone: 253-394-6045 | |
Lakewood Wellness Clinic Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 10310 Gravelly Lake Dr Sw Ste B, Lakewood, WA 98499 Phone: 253-888-3405 | |