Provider Demographics
NPI:1154968428
Name:COOMES, SORCHA CONNOR BOYLE (BCBA, LBA, M ED)
Entity type:Individual
Prefix:
First Name:SORCHA
Middle Name:CONNOR BOYLE
Last Name:COOMES
Suffix:
Gender:F
Credentials:BCBA, LBA, M ED
Other - Prefix:
Other - First Name:SORCHA
Other - Middle Name:
Other - Last Name:CONNOR-BOYLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BCBA, LBA, M ED
Mailing Address - Street 1:947 E 35TH AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99203-3163
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:227 W 3RD AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-3611
Practice Address - Country:US
Practice Address - Phone:509-995-3388
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-05
Last Update Date:2022-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
WABA61165052103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician