Provider Demographics
NPI:1376843060
Name:RALKOWSKI, MANYA CHRISTINE (BCBA)
Entity Type:Individual
Prefix:MRS
First Name:MANYA
Middle Name:CHRISTINE
Last Name:RALKOWSKI
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2414 SW HOLDEN ST APT D
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98106-1735
Mailing Address - Country:US
Mailing Address - Phone:206-384-3702
Mailing Address - Fax:
Practice Address - Street 1:2414 SW HOLDEN ST APT D
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98106-1735
Practice Address - Country:US
Practice Address - Phone:206-384-3702
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-27
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA1-05-2489103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst