Provider Demographics
NPI:1598393837
Name:EMPOWERED LEARNING, INC.
Entity Type:Organization
Organization Name:EMPOWERED LEARNING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BCBA
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:KROCZAK
Authorized Official - Suffix:
Authorized Official - Credentials:MSPECED, BCBA
Authorized Official - Phone:425-736-2816
Mailing Address - Street 1:105B 182ND PL SW
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98012-6204
Mailing Address - Country:US
Mailing Address - Phone:425-736-2816
Mailing Address - Fax:
Practice Address - Street 1:105B 182ND PL SW
Practice Address - Street 2:
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98012-6204
Practice Address - Country:US
Practice Address - Phone:425-736-2816
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-31
Last Update Date:2020-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
1-18-32892OtherBACB
WABA60973206OtherWASHINGTON STATE DOH