Provider Demographics
NPI:1467148320
Name:MILOVANOVIC, DANIJEL (CBT)
Entity Type:Individual
Prefix:
First Name:DANIJEL
Middle Name:
Last Name:MILOVANOVIC
Suffix:
Gender:M
Credentials:CBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2310 130TH AVE NE STE 100
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98005-1757
Mailing Address - Country:US
Mailing Address - Phone:425-882-8868
Mailing Address - Fax:425-633-2282
Practice Address - Street 1:2310 130TH AVE NE STE 100
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-1757
Practice Address - Country:US
Practice Address - Phone:425-882-8868
Practice Address - Fax:425-633-2282
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-13
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACB60954485106S00000X
WABA61538806103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician