Provider Demographics
NPI:1366295529
Name:WILLETTS WAY ABA
Entity type:Organization
Organization Name:WILLETTS WAY ABA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/SENIOR BEHAVIOR ANALYST
Authorized Official - Prefix:
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:WILLETT
Authorized Official - Last Name:YORK
Authorized Official - Suffix:
Authorized Official - Credentials:LBA
Authorized Official - Phone:818-401-5134
Mailing Address - Street 1:10019 15TH PL SE
Mailing Address - Street 2:
Mailing Address - City:LAKE STEVENS
Mailing Address - State:WA
Mailing Address - Zip Code:98258-3830
Mailing Address - Country:US
Mailing Address - Phone:818-401-5134
Mailing Address - Fax:833-992-3922
Practice Address - Street 1:10019 15TH PL SE
Practice Address - Street 2:
Practice Address - City:LAKE STEVENS
Practice Address - State:WA
Practice Address - Zip Code:98258-3830
Practice Address - Country:US
Practice Address - Phone:818-401-5134
Practice Address - Fax:833-992-3922
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-08
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty