Ivy Diane Street

NPI #1609569540 in Kent, Washington

Provider Information

NPI Number: 1609569540
Entity Type: Individual
Name: Ivy Diane Street
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: May 26, 2023
Last Updated: May 26, 2023

Practice Location

Address: 8725 S 212TH ST
City: Kent
State: Washington
ZIP Code: 98031-1921
Phone: (425) 658-3016

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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