Mallory Fraker
Individual provider Active NPI Behavior Technician · Kent, WA
NPI 1336734185 · NPPES record last updated Mar 3, 2021
Key facts
- NPI
- 1336734185
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- Practice address
- 6624 S 196TH St Ste U107
Kent, WA 98032-3113 - Phone
- (800) 249-1266
- NPI assigned
- Mar 3, 2021
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Yes |
Addresses
Primary practice location
6624 S 196TH St Ste U107
Kent, WA 98032-3113
Mailing address
1301 E Orangewood Ave
Anaheim, CA 92805-6807
Other providers in Kent, WA
- David Fowler
- Joanne Marie Fowler
- Carrie Fox
- Spencer Jordan Fox
- Zacheriah Mervin Frafford
- Anthony Waithaka Francis Sr.
- Franciscan City Urgent Care Services
- Alice M Franck
- Sarah Frankel
- Heather Franklin
All providers in Kent, WA · Behavior Technician in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 3, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.