Provider Demographics
NPI:1073985909
Name:IGNACIO, MARIA TRIXY (BCBA)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:TRIXY
Last Name:IGNACIO
Suffix:
Gender:
Credentials:BCBA
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:TRIXY
Other - Last Name:TITCO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3119 13TH AVENUE CT NW
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98371-3893
Mailing Address - Country:US
Mailing Address - Phone:206-851-2106
Mailing Address - Fax:
Practice Address - Street 1:950 BROADWAY STE 301
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98402-4454
Practice Address - Country:US
Practice Address - Phone:253-671-9909
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-30
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WABA61654990103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst