Provider Demographics
NPI:1871891838
Name:DOUVIER, ANN B (BCBA, CCC-SLP)
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:B
Last Name:DOUVIER
Suffix:
Gender:F
Credentials:BCBA, CCC-SLP
Other - Prefix:
Other - First Name:ANN
Other - Middle Name:MARIE
Other - Last Name:BOWENS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CCC-SLP
Mailing Address - Street 1:PO BOX 1862
Mailing Address - Street 2:
Mailing Address - City:VASHON
Mailing Address - State:WA
Mailing Address - Zip Code:98070-1862
Mailing Address - Country:US
Mailing Address - Phone:206-713-7168
Mailing Address - Fax:206-463-9107
Practice Address - Street 1:10421 SW BANK RD
Practice Address - Street 2:UNIT 1
Practice Address - City:VASHON
Practice Address - State:WA
Practice Address - Zip Code:98070-4666
Practice Address - Country:US
Practice Address - Phone:206-713-7168
Practice Address - Fax:206-463-9107
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-28
Last Update Date:2011-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-09-5605103K00000X
WALL60134156235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist