| NPI | 1043671142 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VANESSA RENEE GRACE Owner 360-818-4376 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WA LW60338821) |
| Enumeration Date | 2016-03-16 |
| Last Update Date | 2016-03-16 |