Most Relevant Information
Provider Data
| NPI Number: | 1003648106 |
| Provider Name: | SAM LOCKE |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 08/16/2024 |
| Last Updated: | 08/16/2024 |
Provider Practice Location
23 218TH PL SE
BOTHELL
WA
980218273
Practice Location Phone/Fax
| Phone: | 4252246478 |
| Fax: |
Provider Mailing Location
23 218TH PL SE
BOTHELL
WA
980218273
Provider Mailing Phone/Fax
| Phone: | 4252246478 |
| Fax: |