Provider Demographics
NPI:1184130353
Name:HANSON, JANICE DEANN (LBA, BCBA)
Entity type:Individual
Prefix:
First Name:JANICE
Middle Name:DEANN
Last Name:HANSON
Suffix:
Gender:F
Credentials:LBA, BCBA
Other - Prefix:
Other - First Name:JANICE
Other - Middle Name:DEANN
Other - Last Name:CHITTY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:507 S 309TH CT
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-4068
Mailing Address - Country:US
Mailing Address - Phone:253-466-6463
Mailing Address - Fax:888-255-7921
Practice Address - Street 1:2313 SW 339TH ST
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98023-7730
Practice Address - Country:US
Practice Address - Phone:508-981-3897
Practice Address - Fax:508-981-3897
Is Sole Proprietor?:No
Enumeration Date:2017-12-23
Last Update Date:2021-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WABA61207294103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
WABA61207294OtherLICENSED BEHAVIOR ANALYST CERTIFICATION NUMBER
1-21-51704OtherBOARD CERTIFIED BEHAVIOR ANALYST CERTIFICATION NUMBER