Provider Demographics
NPI:1821687468
Name:MICHAELS, DANIELLE (BCBA)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:MICHAELS
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 1:84 23RD AVE
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:WA
Mailing Address - Zip Code:98354-9346
Mailing Address - Country:US
Mailing Address - Phone:253-921-6009
Mailing Address - Fax:
Practice Address - Street 1:748 MARKET ST # 157
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98402-3737
Practice Address - Country:US
Practice Address - Phone:253-325-4161
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-17
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALABA.AB.61136268106E00000X
WACB61089152106S00000X
WARBT-19-109485106S00000X
WA1-21-51521103K00000X
WABA61204959103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician