| NPI | 1013267251 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TROY D WILLETT Therapist 360-949-2727 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: WA LH60169232) |
| Enumeration Date | 2012-09-14 |
| Last Update Date | 2012-09-14 |