Alexandria Deatherage

NPI #1548777964 in Lakewood, Washington

Provider Information

NPI Number: 1548777964
Entity Type: Individual
Name: Alexandria Deatherage
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Behavior Analyst
Enumeration Date: Jan 8, 2018
Last Updated: Jan 8, 2018

Practice Location

Address: 8815 S TACOMA WAY STE 122
City: Lakewood
State: Washington
ZIP Code: 98499-7011
Phone: (253) 682-0320

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Analyst	103K00000X	Primary

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