| Missing Piece Autism Services | |
|
12005 E 12th Ave Spokane Valley WA 99206-5456 | |
| (509) 795-0777 | |
| Not Available |
| Full Name | Missing Piece Autism Services |
|---|---|
| Speciality | Behavior Analyst |
| Location | 12005 E 12th Ave, Spokane Valley, Washington |
| Authorized Official Name and Position | Renee Peterson (OWNER, BCBA) |
| Authorized Official Contact | 5097950777 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Missing Piece Autism Services 12005 E 12th Ave Spokane Valley WA 99206-5456 Ph: () - | Missing Piece Autism Services 12005 E 12th Ave Spokane Valley WA 99206-5456 Ph: (509) 795-0777 |
| NPI Number | 1144946401 |
|---|---|
| Provider Enumeration Date | 10/18/2022 |
| Last Update Date | 10/18/2022 |
| Certification Date | 10/18/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144946401 | NPI | - | NPPES |
| 2098134 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
| 106S00000X | Behavior Technician | (* (Not Available)) | Secondary |
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