Mallory Fraker
Behavior Technician in Kent, WA. Individual provider (NPI-1).
NPI number1336734185
StatusActive
Last updated in NPPESMar 3, 2021
Details
- NPI
- 1336734185
- Entity type
- Individual (NPI-1)
- Name
- Mallory Fraker
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 3, 2021
- Certification date
- Mar 3, 2021
- Last updated
- Mar 3, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | – | Yes |
Practice location
6624 S 196th St Ste U107Kent, WA 98032-3113
Phone 800-249-1266
Mailing address
1301 E Orangewood AveAnaheim, CA 92805-6807
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